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Lack of active SARS-CoV-2 virus in a subset of PCR-positive COVID-19 congregate care patients.

Authors
  • Singh, Amit K1
  • Stellrecht, Kathleen A2
  • Arunachalam, Thilaka3
  • Barman, Tarani K1
  • Robek, Michael D1
  • Waxman, Michael J3
  • Elmendorf, Sarah L4
  • Metzger, Dennis W5
  • 1 Departments of Immunology and Microbial Disease, Albany Medical Center, Albany, NY, United States. , (United States)
  • 2 Departments of Immunology and Microbial Disease, Albany Medical Center, Albany, NY, United States; Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, United States. , (United States)
  • 3 Emergency Medicine, Albany Medical Center, Albany, NY, United States. , (United States)
  • 4 Epidemiology, Albany Medical Center, Albany, NY, United States. , (United States)
  • 5 Departments of Immunology and Microbial Disease, Albany Medical Center, Albany, NY, United States. Electronic address: [email protected] , (United States)
Type
Published Article
Journal
Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology
Publication Date
Aug 01, 2021
Volume
141
Pages
104879–104879
Identifiers
DOI: 10.1016/j.jcv.2021.104879
PMID: 34153860
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Highly sensitive nucleic acid amplification tests (NAATs) designed to detect SARS-CoV-2 RNA are the standard of care for the diagnosis of COVID-19. However, the accuracy of these methods for the quantitation of active virus rather than non-infectious RNA fragments that can persist for extended periods of time has been unclear. This issue is particularly relevant for congregate care patients who are unable to return to their home residence until fully negative by NAATs. We tested paired samples from individual patients for the presence of virus at both early and later stages of disease. Culture of nasopharyngeal swab samples for 10 days in Vero E6 cells revealed active virus in only 4 out of 14 (28.6%) patients. The ability to isolate viral plaque-forming units (PFU) correlated with viral RNA loads of >6.79 log genomic copies/ml and only occurred in samples collected from patients early after symptom onset and before development of antibody. Culture in Vero E6 cells lacking the STAT1-dependent interferon signaling pathway increased the numbers of viral PFU detected but did not affect the incidence of positive cultures. We conclude that culturable virus is correlated with SARS-CoV-2 NAATs detection only during early symptom onset and with high viral titers/low antibody titers in non-immunosuppressed patients. Copyright © 2021. Published by Elsevier B.V.

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