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Viral kinetics in SARS-CoV-2 infected asymptomatic patients

K. D. S. T. Abeywardana iD, S. N. Janage iD, L. S. Athukorala iD, Y. Y. Udawatta, R. S. Sudararaj, A. W. R. Dharmasiri, N. D. S. Arachchige

Sri Lankan Journal of Infectious Diseases 12(1) · 2022

https://doi.org/10.4038/sljid.v12i1.8434

Abstract

Introduction: As the daily number of patients diagnosed with SARS-CoV-2 infection by PCR increases, the necessity to identify truly infectious cases becomes more significant. We aimed to identify a cut-off Ct value of the COVID-19 RT-PCR assay for likely infectivity by assessing the COVID-19 IgG status and investigating the utility of the Rapid Antigen Test (RAT) in identifying infectious cases among asymptomatic individuals. Methods: Nasopharyngeal/throat swabs were simultaneously taken for COVID-19 RT-PCR and RAT from 552 asymptomatic individuals at De Soysa Maternity Hospital, Colombo, from 23rd of November to 19th of December 2020. In addition, SARS-CoV-2 IgG (against nucleoprotein) status in PCR positive individuals was evaluated when simultaneously taken sera was available. Results: COVID-19 RT-PCR positive rate among asymptomatic individuals was 14.3% (n=79). The overall sensitivity of RAT was 30.4% but increased to 73.9% when Ct values below 25 were considered. The COVID-19 IgG response was evaluated in 37 PCR positive subjects and the overall seropositivity was 40.5%. The optimal Ct thresholds for discrimination of COVID-19 IgG status were 30.5 and 30.29 for the E and S gene respectively. There was a significant positive correlation between Ct values of the E gene and IgG ratio values (r=0.345, p

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