Risk Factors for Slow Viral Decline in COVID-19 Patients during the 2022 Omicron Wave

Xin Li; Anthony Raymond Tam; Wing-Ming Chu; Wan-Mui Chan; Jonathan Daniel Ip; Allen Wing-Ho Chu; Syed Muhammad Umer Abdullah; Cyril Chik-Yan Yip; Kwok-Hung Chan; Samson Sai-Yin Wong; Vincent Chi-Chung Cheng; Kwok-Yung Yuen; Ivan Fan-Ngai Hung; Kelvin Kai-Wang To

doi:10.3390/v14081714

Risk Factors for Slow Viral Decline in COVID-19 Patients during the 2022 Omicron Wave

Xin Li, Anthony Raymond Tam, Wing-Ming Chu, Wan-Mui Chan, Jonathan Daniel Ip, Allen Wing-Ho Chu, Syed Muhammad Umer Abdullah, Cyril Chik-Yan Yip, Kwok-Hung Chan, Samson Sai-Yin Wong, Vincent Chi-Chung Cheng, Kwok-Yung Yuen, Ivan Fan-Ngai Hung, Kelvin Kai-Wang To^*

^*Corresponding author for this work

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

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Abstract

Formulating termination of isolation (de-isolation) policies requires up-to-date knowledge about viral shedding dynamics. However, current de-isolation policies are largely based on viral load data obtained before the emergence of Omicron variant. In this retrospective cohort study involving adult patients hospitalised for COVID-19 between January and February 2022, we sought to determine SARS-CoV-2 viral shedding kinetics and to investigate the risk factors associated with slow viral decline during the 2022 Omicron wave. A total of 104 patients were included. The viral load was highest (Ct value was lowest) on days 1 post-symptom-onset (PSO) and gradually declined. Older age, hypertension, hyperlipidaemia and chronic kidney disease were associated with slow viral decline in the univariate analysis on both day 7 and day 10 PSO, while incomplete or no vaccination was associated with slow viral decline on day 7 PSO only. However, older age was the only risk factor that remained statistically significant in the multivariate analysis. In conclusion, older age is an independent risk factor associated with slow viral decline in this study conducted during the Omicron-dominant 2022 COVID-19 wave. Transmission-based precaution guidelines should take age into consideration when determining the timing of de-isolation.

Original language	English
Article number	1714
Journal	Viruses
Volume	14
Issue number	8
Online published	4 Aug 2022
DOIs	https://doi.org/10.3390/v14081714
Publication status	Published - Aug 2022
Externally published	Yes

Funding

This work was funded by the Consultancy Service for Enhancing Laboratory Surveillance of Emerging Infectious Diseases and Research Capability on Antimicrobial Resistance for Department of Health of the Hong Kong; the Theme-Based Research Scheme (T11/707/15) of the Research Grants Council, Hong Kong Special Administrative Region; Emerging Collaborative Project of Guangzhou Laboratory (EKPG22-01); Emergency COVID-19 Project (2021YFC0866100), Major Projects on Public Security, National Key Research and Development Program; and the donations of the Shaw Foundation Hong Kong, Richard Yu and Carol Yu, May Tam Mak Mei Yin, Michael Seak-Kan Tong, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Chan Yin Chuen Memorial Charitable Foundation, and Marina Man-Wai Lee.

Research Keywords

SARS-CoV-2
COVID-19
omicron variant
delta variant
viral shedding
geriatrics

Publisher's Copyright Statement

This full text is made available under CC-BY 4.0. https://creativecommons.org/licenses/by/4.0/

RGC Funding Information

RGC-funded

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3390/v14081714

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title = "Risk Factors for Slow Viral Decline in COVID-19 Patients during the 2022 Omicron Wave",

abstract = "Formulating termination of isolation (de-isolation) policies requires up-to-date knowledge about viral shedding dynamics. However, current de-isolation policies are largely based on viral load data obtained before the emergence of Omicron variant. In this retrospective cohort study involving adult patients hospitalised for COVID-19 between January and February 2022, we sought to determine SARS-CoV-2 viral shedding kinetics and to investigate the risk factors associated with slow viral decline during the 2022 Omicron wave. A total of 104 patients were included. The viral load was highest (Ct value was lowest) on days 1 post-symptom-onset (PSO) and gradually declined. Older age, hypertension, hyperlipidaemia and chronic kidney disease were associated with slow viral decline in the univariate analysis on both day 7 and day 10 PSO, while incomplete or no vaccination was associated with slow viral decline on day 7 PSO only. However, older age was the only risk factor that remained statistically significant in the multivariate analysis. In conclusion, older age is an independent risk factor associated with slow viral decline in this study conducted during the Omicron-dominant 2022 COVID-19 wave. Transmission-based precaution guidelines should take age into consideration when determining the timing of de-isolation.",

keywords = "SARS-CoV-2, COVID-19, omicron variant, delta variant, viral shedding, geriatrics",

author = "Xin Li and Tam, {Anthony Raymond} and Wing-Ming Chu and Wan-Mui Chan and Ip, {Jonathan Daniel} and Chu, {Allen Wing-Ho} and Abdullah, {Syed Muhammad Umer} and Yip, {Cyril Chik-Yan} and Kwok-Hung Chan and Wong, {Samson Sai-Yin} and Cheng, {Vincent Chi-Chung} and Kwok-Yung Yuen and Hung, {Ivan Fan-Ngai} and To, {Kelvin Kai-Wang}",

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doi = "10.3390/v14081714",

language = "English",

volume = "14",

journal = "Viruses",

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AU - Li, Xin

AU - Tam, Anthony Raymond

AU - Chu, Wing-Ming

AU - Chan, Wan-Mui

AU - Ip, Jonathan Daniel

AU - Chu, Allen Wing-Ho

AU - Abdullah, Syed Muhammad Umer

AU - Yip, Cyril Chik-Yan

AU - Chan, Kwok-Hung

AU - Wong, Samson Sai-Yin

AU - Cheng, Vincent Chi-Chung

AU - Yuen, Kwok-Yung

AU - Hung, Ivan Fan-Ngai

AU - To, Kelvin Kai-Wang

PY - 2022/8

Y1 - 2022/8

N2 - Formulating termination of isolation (de-isolation) policies requires up-to-date knowledge about viral shedding dynamics. However, current de-isolation policies are largely based on viral load data obtained before the emergence of Omicron variant. In this retrospective cohort study involving adult patients hospitalised for COVID-19 between January and February 2022, we sought to determine SARS-CoV-2 viral shedding kinetics and to investigate the risk factors associated with slow viral decline during the 2022 Omicron wave. A total of 104 patients were included. The viral load was highest (Ct value was lowest) on days 1 post-symptom-onset (PSO) and gradually declined. Older age, hypertension, hyperlipidaemia and chronic kidney disease were associated with slow viral decline in the univariate analysis on both day 7 and day 10 PSO, while incomplete or no vaccination was associated with slow viral decline on day 7 PSO only. However, older age was the only risk factor that remained statistically significant in the multivariate analysis. In conclusion, older age is an independent risk factor associated with slow viral decline in this study conducted during the Omicron-dominant 2022 COVID-19 wave. Transmission-based precaution guidelines should take age into consideration when determining the timing of de-isolation.

AB - Formulating termination of isolation (de-isolation) policies requires up-to-date knowledge about viral shedding dynamics. However, current de-isolation policies are largely based on viral load data obtained before the emergence of Omicron variant. In this retrospective cohort study involving adult patients hospitalised for COVID-19 between January and February 2022, we sought to determine SARS-CoV-2 viral shedding kinetics and to investigate the risk factors associated with slow viral decline during the 2022 Omicron wave. A total of 104 patients were included. The viral load was highest (Ct value was lowest) on days 1 post-symptom-onset (PSO) and gradually declined. Older age, hypertension, hyperlipidaemia and chronic kidney disease were associated with slow viral decline in the univariate analysis on both day 7 and day 10 PSO, while incomplete or no vaccination was associated with slow viral decline on day 7 PSO only. However, older age was the only risk factor that remained statistically significant in the multivariate analysis. In conclusion, older age is an independent risk factor associated with slow viral decline in this study conducted during the Omicron-dominant 2022 COVID-19 wave. Transmission-based precaution guidelines should take age into consideration when determining the timing of de-isolation.

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Risk Factors for Slow Viral Decline in COVID-19 Patients during the 2022 Omicron Wave

Abstract

Funding

Research Keywords

Publisher's Copyright Statement

RGC Funding Information

UN SDGs

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