Clinical characteristics and viral load dynamics of COVID-19 in a mildly or moderately symptomatic outpatient sample

Studies of outpatients with mild or moderate COVID-19 are uncommon. We studied: 1) association of symptoms with reverse transcriptase polymerase chain reaction (RT-PCR) test results; and 2) association of initial RT-PCR cycle threshold (Ct) in relation to duration of RT-PCR positivity in outpatients...

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Bibliographic Details
Published in:PloS one 2021-10, Vol.16 (10), p.e0258970-e0258970
Main Authors: Caplan, Amanda, Bates, Kelly W, Brioni, Carla, Santos, Aileen, Sabatini, Linda M, Kaul, Karen L, Carnethon, Mercedes R, Khandekar, Janardan D, Greenland, Philip
Format: Article
Language:English
Subjects:
Antibodies
Care and treatment
Check lists
Coronaviruses
COVID-19
Disease control
DNA polymerases
Headaches
Health care
Hospitalization
Illnesses
Infections
Measurement
Medical laboratories
Outpatients
Patients
Polymerase chain reaction
Preventive medicine
RNA-directed DNA polymerase
Severe acute respiratory syndrome coronavirus 2
Testing
Viral antibodies
Viral diseases
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Summary:Studies of outpatients with mild or moderate COVID-19 are uncommon. We studied: 1) association of symptoms with reverse transcriptase polymerase chain reaction (RT-PCR) test results; and 2) association of initial RT-PCR cycle threshold (Ct) in relation to duration of RT-PCR positivity in outpatients with mild or moderate COVID-19. This was a cohort study of outpatients with confirmed COVID-19 and at least one symptom. Participants had repeat nasopharyngeal swabs and symptom checklists every 3-5 days until two consecutive RT-PCR tests were negative. RT-PCR tests were used to assess viral load. Antibody tests for COVID-19 were performed at 2 weeks, 4 weeks, and 8 weeks after symptom onset. Twenty-five patients (nine females) were enrolled, ranging in age from 19-58 (median age 28 years). All patients reported at least one symptom, with a median of six symptoms per patient. Symptoms persisted for 6-67 days (median duration 18 days). In all 25 patients, blood samples collected a median of 13 days after symptom onset were positive for SARS-CoV-2 antibodies in 15 (60%). After a median of 28 days following symptom onset, 23/23 patients with available samples tested positive for antibodies. The longest duration of positive RT-PCR test was 49 days from first positive PCR test (Mean = 27.4, SD = 12.5, Median = 24). Initial Ct was significantly associated with longer duration ([beta] = -1.3, SE = 0.3, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0258970