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Persistence of SARS-CoV-2 nasopharyngeal swab PCR positivity in COVID-19 convalescent plasma donors.
Transfusion. 2020 12; 60(12):2962-2968.T

Abstract

BACKGROUND

Nucleic acid persists after symptom resolution and infectivity for many viral infections via delayed clearance of nucleic acid fragments, non-infectious particles, or transmissible virus. For Coronavirus Disease 2019 (COVID-19), the relationship between nasopharyngeal (NP) swab positivity, the development of antibodies against COVID-19, and clinical history are unclear.

STUDY DESIGN AND METHODS

Individuals who recovered from COVID-19 and volunteered to donate convalescent plasma (CP) were screened by NP swab PCR, responded to a questionnaire, and were tested for anti-COVID-19 antibodies.

RESULTS

A proportion of 11.8% of individuals tested positive for SARS-CoV-2 by NP swab PCR greater than 14 days after the resolution of symptoms of active disease, including one donor who had asymptomatic disease and tested positive by NP swab 41 days after her initial diagnosis. Clinical history did not show a significant correlation with persistence of NP swab positivity. Also, NP swab positivity >14 days from symptom resolution did not correlate with anti-COVID-19 serology results. IgG anti-SARS-CoV-2 spike antibody strength correlated with hospitalization for COVID-19 using two different assays. Total anti-SARS-CoV-2 nucleocapsid antibody strength correlated with time from symptom resolution to sample collection and symptom duration.

CONCLUSIONS

SARS-CoV-2 nucleic acid is detectable long after the resolution of symptoms in a significant percentage of previously diagnosed individuals, which is important to consider when interpreting PCR swab results. Persistence of PCR positivity does not correlate with antibody strength or symptoms of COVID-19. If anti-spike antibody is used to assess CP potency, individuals who suffered severe COVID-19 disease symptoms may represent better donors.

Authors+Show Affiliations

Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA.Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA.NorthShore University HealthSystem, Evanston, Illinois, USA.NorthShore University HealthSystem, Evanston, Illinois, USA.NorthShore University HealthSystem, Evanston, Illinois, USA.NorthShore University HealthSystem, Evanston, Illinois, USA.NorthShore University HealthSystem, Evanston, Illinois, USA.Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA.Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA.NorthShore University HealthSystem, Swedish Hospital, Chicago, Illinois, USA.Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA.Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA.

Pub Type(s)

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

Language

eng

PubMed ID

32840002

Citation

Ikegami, Sachie, et al. "Persistence of SARS-CoV-2 Nasopharyngeal Swab PCR Positivity in COVID-19 Convalescent Plasma Donors." Transfusion, vol. 60, no. 12, 2020, pp. 2962-2968.
Ikegami S, Benirschke R, Flanagan T, et al. Persistence of SARS-CoV-2 nasopharyngeal swab PCR positivity in COVID-19 convalescent plasma donors. Transfusion. 2020;60(12):2962-2968.
Ikegami, S., Benirschke, R., Flanagan, T., Tanna, N., Klein, T., Elue, R., Debosz, P., Mallek, J., Wright, G., Guariglia, P., Kang, J., & Gniadek, T. J. (2020). Persistence of SARS-CoV-2 nasopharyngeal swab PCR positivity in COVID-19 convalescent plasma donors. Transfusion, 60(12), 2962-2968. https://doi.org/10.1111/trf.16015
Ikegami S, et al. Persistence of SARS-CoV-2 Nasopharyngeal Swab PCR Positivity in COVID-19 Convalescent Plasma Donors. Transfusion. 2020;60(12):2962-2968. PubMed PMID: 32840002.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistence of SARS-CoV-2 nasopharyngeal swab PCR positivity in COVID-19 convalescent plasma donors. AU - Ikegami,Sachie, AU - Benirschke,Robert, AU - Flanagan,Tara, AU - Tanna,Nicole, AU - Klein,Tovah, AU - Elue,Rita, AU - Debosz,Patricia, AU - Mallek,Jessica, AU - Wright,Gregory, AU - Guariglia,Perry, AU - Kang,Jason, AU - Gniadek,Thomas J, Y1 - 2020/08/24/ PY - 2020/05/17/received PY - 2020/07/21/revised PY - 2020/07/21/accepted PY - 2020/8/26/pubmed PY - 2020/12/29/medline PY - 2020/8/26/entrez SP - 2962 EP - 2968 JF - Transfusion JO - Transfusion VL - 60 IS - 12 N2 - BACKGROUND: Nucleic acid persists after symptom resolution and infectivity for many viral infections via delayed clearance of nucleic acid fragments, non-infectious particles, or transmissible virus. For Coronavirus Disease 2019 (COVID-19), the relationship between nasopharyngeal (NP) swab positivity, the development of antibodies against COVID-19, and clinical history are unclear. STUDY DESIGN AND METHODS: Individuals who recovered from COVID-19 and volunteered to donate convalescent plasma (CP) were screened by NP swab PCR, responded to a questionnaire, and were tested for anti-COVID-19 antibodies. RESULTS: A proportion of 11.8% of individuals tested positive for SARS-CoV-2 by NP swab PCR greater than 14 days after the resolution of symptoms of active disease, including one donor who had asymptomatic disease and tested positive by NP swab 41 days after her initial diagnosis. Clinical history did not show a significant correlation with persistence of NP swab positivity. Also, NP swab positivity >14 days from symptom resolution did not correlate with anti-COVID-19 serology results. IgG anti-SARS-CoV-2 spike antibody strength correlated with hospitalization for COVID-19 using two different assays. Total anti-SARS-CoV-2 nucleocapsid antibody strength correlated with time from symptom resolution to sample collection and symptom duration. CONCLUSIONS: SARS-CoV-2 nucleic acid is detectable long after the resolution of symptoms in a significant percentage of previously diagnosed individuals, which is important to consider when interpreting PCR swab results. Persistence of PCR positivity does not correlate with antibody strength or symptoms of COVID-19. If anti-spike antibody is used to assess CP potency, individuals who suffered severe COVID-19 disease symptoms may represent better donors. SN - 1537-2995 UR - https://www.unboundmedicine.com/medline/citation/32840002/Persistence_of_SARS_CoV_2_nasopharyngeal_swab_PCR_positivity_in_COVID_19_convalescent_plasma_donors_ L2 - https://doi.org/10.1111/trf.16015 DB - PRIME DP - Unbound Medicine ER -