Chronological changes of viral shedding in adult inpatients with Omicron infection in Shanghai, China

Xinru Zhou; Xiaochun Huang; Tingting Sun; Xiaolan Jin; Zhaofeng Tian; Miao Xue; Jinsong Kang; Bai Gao; Aijing Xu; Yi Chen; Yin Jia; Shanrong Liu

doi:10.3389/fimmu.2023.1090498

Chronological changes of viral shedding in adult inpatients with Omicron infection in Shanghai, China

Front Immunol. 2023 Feb 1:14:1090498. doi: 10.3389/fimmu.2023.1090498. eCollection 2023.

Authors

Xinru Zhou¹, Xiaochun Huang¹, Tingting Sun¹, Xiaolan Jin¹, Zhaofeng Tian¹, Miao Xue¹, Jinsong Kang¹, Bai Gao², Aijing Xu³, Yi Chen³, Yin Jia¹, Shanrong Liu¹

Affiliations

¹ Department of Laboratory Diagnostics, Changhai Hospital, Second Military Medical University, Shanghai, China.
² Information Department, Changhai Hospital, Second Military Medical University, Shanghai, China.
³ Infectious Department, Changhai Hospital, Second Military Medical University, Shanghai, China.

Abstract

Background: Coronavirus disease 2019 (COVID-19) caused by the Omicron variant occurred in Shanghai, China, but its clinical characteristics and virology have not been comprehensively described.

Methods: This retrospective cohort study included adult inpatients (≥18 years) diagnosed with COVID-19 at Changhai Hospital. Laboratory and clinical data were obtained from electronic medical records to investigate the clinical characteristics of COVID-19 and the variations in the patients' laboratory indexes were examined.

Results: The symptoms of COVID-19 caused by the Omicron variant were relatively mild. Upper respiratory tract specimens yielded higher positive detection rates than lower respiratory tract and intestinal specimens. Peak COVID-19 viral load was reached at the time of admission; quantification cycle (Cq) values increased to approximately 35 after 8.54 days. In vivo viral shedding duration correlated with age and disease severity (p<0.05). The older the patient and the more severe the disease, the longer the duration of viral shedding was. Portion parameters of blood routine, coagulative function, clinical chemistry, and inflammatory factor showed a certain correlation with the SARS-CoV-2 viral load.

Conclusions: Virus replication and shedding are rapid in Omicron-positive patients; COVID-19 in these patients is characterized by acute onset, mild symptoms, and fast recovery. Older patients and those with more severe disease demonstrate prolonged virus shedding. Routine hematological indexes can reveal disease severity and help clinically evaluate the patient's condition.

Keywords: Omicron; coronavirus disease 2019; quantification cycle; severe acute respiratory syndrome coronavirus 2; viral load.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19*
China
Humans
Inpatients
Retrospective Studies
SARS-CoV-2
Virus Shedding

Supplementary concepts

SARS-CoV-2 variants

Grants and funding

This work was supported by the Shanghai “Rising Stars of Medical Talents” Youth Development Program, Youth Medical Talents-Clinical Laboratory Practitioner Program (2020) and Changhai Hospital’s COVID-19 Jizhi Scientific Research Project.