Implications in the quantification of SARS-CoV2 copies in concurrent nasopharyngeal swabs, whole mouth fluid and respiratory droplets

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Kannian, P
Jayaraman, BG
Alamelu, S
Lavanya, C
Kumarasamy, N
Rajan, G
Ranganathan, K
Mahanathi, P
Ashwini, V
Challacombe, SJ
Webster-Cyriaque, J
Johnson, NW
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2021
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Abstract

Objective: Association of SARS-CoV2 burden in the aerodigestive tract with the disease is sparsely understood. We propose to elucidate the implications of SARS-CoV2 copies in concurrent nasopharyngeal swab (NPS), whole mouth fluid (WMF) and respiratory droplet (RD) samples on disease pathogenesis/transmission. Methods: SARS-CoV2 copies quantified by RT-PCR in concurrent NPS, WMF and RD samples from 80 suspected COVID-19 patients were analysed with demographics, immune response and disease severity. Results: Among the 55/80 (69 %) NPS-positive patients, SARS-CoV2 was detected in 44/55 (80 %) WMF (concordance with NPS-84 %; p = 0.02) and 17/55 (31 %) RD samples. SARS-CoV2 copies were similar in NPS (median:8.74 × 10^5) and WMF (median:3.07 × 10^4), but lower in RD (median:3.60 × 10^2). The 25–75 % interquartile range of SARS-CoV2 copies in the NPS was significantly higher in patients who shed the virus in WMF (p = 0.0001) and RD (p = 0.01). Multivariate analyses showed that hospitalized patients shed significantly higher virus copies in the WMF (p = 0.01). Hospitalized patients with more severe disease (p = 0.03) and higher IL-6 values (p = 0.001) shed more SARS-CoV2 virus in the RD. Conclusions: WMF may be used reliably as a surrogate for diagnosis. High copy numbers in the NPS probably imply early disease onset, while in the WMF and RD may imply more severe disease and increased inflammation.

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Virus Research

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© 2021 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.

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Biological sciences

Agricultural, veterinary and food sciences

Biomedical and clinical sciences

Nasopharyngeal swab

Quantification

Respiratory droplet

SARS-CoV2

Whole mouth fluid

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Kannian, P; Jayaraman, BG; Alamelu, S; Lavanya, C; Kumarasamy, N; Rajan, G; Ranganathan, K; Mahanathi, P; Ashwini, V; Challacombe, SJ; Webster-Cyriaque, J; Johnson, NW, Implications in the quantification of SARS-CoV2 copies in concurrent nasopharyngeal swabs, whole mouth fluid and respiratory droplets, Virus Research, 2021, pp. 198442

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