Infectious SARS-CoV-2 Virus in Symptomatic COVID-19 Outpatients: Host, Disease, and Viral Correlates.

COVID-19 SARS-CoV-2 infectious virus outpatient serostatus

Journal

medRxiv : the preprint server for health sciences
Titre abrégé: medRxiv
Pays: United States
ID NLM: 101767986

Informations de publication

Date de publication:
25 Jun 2021
Historique:
pubmed: 9 6 2021
medline: 9 6 2021
entrez: 8 6 2021
Statut: epublish

Résumé

While SARS-CoV-2 infectious virus isolation in outpatients with COVID-19 has been associated with viral RNA levels and symptom duration, little is known about the host, disease and viral determinants of infectious virus detection. COVID-19 adult outpatients were enrolled within 7 days of symptom onset. Clinical symptoms were recorded via patient diary. Nasopharyngeal swabs were collected to quantitate SARS-CoV-2 RNA by reverse transcriptase polymerase chain reaction and for infectious virus isolation in Vero E6-cells. SARS-CoV-2 antibodies were measured in serum using a validated ELISA assay. Among 204 participants with mild-to-moderate symptomatic COVID19, the median nasopharyngeal viral RNA was 6.5 (IQR 4.7-7.6 log The presence of SARS-CoV-2 antibodies is strongly associated with clearance of infectious virus isolation. Seropositivity and viral RNA levels are likely more reliable markers of infectious virus clearance than subjective measure of COVID-19 symptom duration. Virus-targeted treatment and prevention strategies should be administered as early as possible and ideally before seroconversion. NCT04405570.

Sections du résumé

BACKGROUND BACKGROUND
While SARS-CoV-2 infectious virus isolation in outpatients with COVID-19 has been associated with viral RNA levels and symptom duration, little is known about the host, disease and viral determinants of infectious virus detection.
METHODS METHODS
COVID-19 adult outpatients were enrolled within 7 days of symptom onset. Clinical symptoms were recorded via patient diary. Nasopharyngeal swabs were collected to quantitate SARS-CoV-2 RNA by reverse transcriptase polymerase chain reaction and for infectious virus isolation in Vero E6-cells. SARS-CoV-2 antibodies were measured in serum using a validated ELISA assay.
RESULTS RESULTS
Among 204 participants with mild-to-moderate symptomatic COVID19, the median nasopharyngeal viral RNA was 6.5 (IQR 4.7-7.6 log
CONCLUSIONS CONCLUSIONS
The presence of SARS-CoV-2 antibodies is strongly associated with clearance of infectious virus isolation. Seropositivity and viral RNA levels are likely more reliable markers of infectious virus clearance than subjective measure of COVID-19 symptom duration. Virus-targeted treatment and prevention strategies should be administered as early as possible and ideally before seroconversion.
CLINICALTRIALSGOV IDENTIFIER BACKGROUND
NCT04405570.

Identifiants

pubmed: 34100024
doi: 10.1101/2021.05.28.21258011
pmc: PMC8183023
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT04405570']

Types de publication

Preprint

Langues

eng

Subventions

Organisme : NIAID NIH HHS
ID : P30 AI027757
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI050410
Pays : United States
Organisme : NIEHS NIH HHS
ID : T32 ES007018
Pays : United States
Organisme : NIAID NIH HHS
ID : UM1 AI106701
Pays : United States

Commentaires et corrections

Type : UpdateIn

Auteurs

Katie R Mollan (KR)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Joseph J Eron (JJ)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Taylor J Krajewski (TJ)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Wendy Painter (W)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Elizabeth R Duke (ER)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Caryn G Morse (CG)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Erin A Goecker (EA)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Lakshmanane Premkumar (L)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Cameron R Wolfe (CR)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Laura J Szewczyk (LJ)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Paul L Alabanza (PL)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Amy James Loftis (AJ)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Emily J Degli-Angeli (EJ)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Ariane J Brown (AJ)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Joan A Dragavon (JA)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

John J Won (JJ)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Jessica Keys (J)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Michael G Hudgens (MG)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Lei Fang (L)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

David A Wohl (DA)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Myron S Cohen (MS)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Ralph S Baric (RS)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Robert W Coombs (RW)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

Timothy P Sheahan (TP)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

William A Fischer (WA)

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, AJB, JJW, MGH, RSB, TPS); School of Medicine, University of North Carolina at Chapel Hill, NC (KRM, JJE, LP, AJL, DAW, WAF); Center for AIDS Research, University of North Carolina at Chapel Hill, NC (KRM, JJE, TJK, PLA, JK, MGH); Ridgeback Biotherapeutics LP, Miami, Florida (WP, LJS); Fred Hutchinson Cancer Research Center, Seattle, WA (ERD); Wake Forest School of Medicine, Winston-Salem, NC (CGM); Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA (EAG, EJDA, JAD, RWC); Duke University Medical Center, Durham, NC (CRW); Pharstat Inc., Raleigh, NC (LF); Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, NC (WAF).

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