High Amounts of SARS-CoV-2 Precede Sickness Among Asymptomatic Health Care Workers.
Adult
Aged
Antibodies, Viral
Asymptomatic Diseases
COVID-19
/ diagnosis
Disease Progression
Female
Health Personnel
Hospitals, University
Humans
Male
Mass Screening
Middle Aged
Polymerase Chain Reaction
RNA, Viral
SARS-CoV-2
/ genetics
Serologic Tests
Sick Leave
/ statistics & numerical data
Sweden
/ epidemiology
Young Adult
SARS-CoV-2
antibodies
coronavirus
health care workers
sick leave
Journal
The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675
Informations de publication
Date de publication:
02 07 2021
02 07 2021
Historique:
received:
16
12
2020
accepted:
11
02
2021
pubmed:
14
2
2021
medline:
20
7
2021
entrez:
13
2
2021
Statut:
ppublish
Résumé
Whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity among asymptomatic subjects reflects past or future disease may be difficult to ascertain. We tested 9449 employees at Karolinska University Hospital, Stockholm, Sweden for SARS-CoV-2 RNA and antibodies, linked the results to sick leave records, and determined associations with past or future sick leave using multinomial logistic regression. Subjects with high amounts of SARS-CoV-2 virus, indicated by polymerase chain reaction (PCR) cycle threshold (Ct) value, had the highest risk for sick leave in the 2 weeks after testing (odds ratio [OR], 11.97; 95% confidence interval [CI], 6.29-22.80) whereas subjects with low amounts of virus had the highest risk for sick leave in the 3 weeks before testing (OR, 6.31; 95% CI, 4.38-9.08). Only 2.5% of employees were SARS-CoV-2 positive while 10.5% were positive by serology and 1.2% were positive in both tests. Serology-positive subjects were not at excess risk for future sick leave (OR, 1.06; 95% CI, .71-1.57). High amounts of SARS-CoV-2 virus, as determined using PCR Ct values, was associated with development of sickness in the next few weeks. Results support the concept that PCR Ct may be informative when testing for SARS-CoV-2. Clinical Trials Registration. NCT04411576.
Sections du résumé
BACKGROUND
Whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity among asymptomatic subjects reflects past or future disease may be difficult to ascertain.
METHODS
We tested 9449 employees at Karolinska University Hospital, Stockholm, Sweden for SARS-CoV-2 RNA and antibodies, linked the results to sick leave records, and determined associations with past or future sick leave using multinomial logistic regression.
RESULTS
Subjects with high amounts of SARS-CoV-2 virus, indicated by polymerase chain reaction (PCR) cycle threshold (Ct) value, had the highest risk for sick leave in the 2 weeks after testing (odds ratio [OR], 11.97; 95% confidence interval [CI], 6.29-22.80) whereas subjects with low amounts of virus had the highest risk for sick leave in the 3 weeks before testing (OR, 6.31; 95% CI, 4.38-9.08). Only 2.5% of employees were SARS-CoV-2 positive while 10.5% were positive by serology and 1.2% were positive in both tests. Serology-positive subjects were not at excess risk for future sick leave (OR, 1.06; 95% CI, .71-1.57).
CONCLUSIONS
High amounts of SARS-CoV-2 virus, as determined using PCR Ct values, was associated with development of sickness in the next few weeks. Results support the concept that PCR Ct may be informative when testing for SARS-CoV-2. Clinical Trials Registration. NCT04411576.
Identifiants
pubmed: 33580261
pii: 6134453
doi: 10.1093/infdis/jiab099
pmc: PMC7928785
doi:
Substances chimiques
Antibodies, Viral
0
RNA, Viral
0
Banques de données
ClinicalTrials.gov
['NCT04411576']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
14-20Subventions
Organisme : Karolinska University Hospital
Organisme : County Council of Stockholm
Organisme : Knut and Alice Wallenberg Foundation
Organisme : Erling-Persson Family Foundation
Organisme : KTH Royal Institute of Technology
Organisme : SciLifeLab
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.