感染後の感染性ウイルスの排出期間①

JCI Insight. 2022;7(2):e155483. https://doi.org/10.1172/jci.insight.155483.

感染後の感染性ウイルスの排出期間①
Duration of viral shedding and culture _
positivity with postvaccination SARS- 邊一一 人 ce
CoV-2 delta variant infections 0

Mark」. Siedner “julie Boucau Rebecca F. Gilbert,! Rockib Uddin,「 jonathan Luu,*
Sebastien Haneuse,* Tammy Vyas,' Zahra Reynolds,' Surabhi lyer' Grace C. Chamberlin,

Robert H. Goldstein,“Crystal M. North,"“ Chana A. Sacks,"“ james Regan,* james P Flynn,* 急、 Nasal swabs collected 3x
ュ 。 。 。 weekiy from time of index
Manish C. Choudhary,人“Jatin M. Vyas,“ Amy K. Barczak,"人acob E. Lemieux,"ぐand jonathan Z. Li7* positive test until day 14 or
negative PCR
IMassachusetts General Hospital, Boston, Massachusetts, USA. 2Harvard Medical School, Boston, Massachusetts, USA. ] TA
3Ragon Institute of MGH, MIT and Harvard and ?Harvard TH. Chan School of Public Health, Boston, Massachusetts, USA. ング

3Brigham and Women's Hospital, Boston, Massachusetts, USA. Broad Institute, Cambridge, Massachusetts, USA

Specimens evaluated

by PCR for viral load,

sequencing, and viral
culture

Isolation guidelines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are largely
derived from data collected prior to the emergence of the delta variant. We followed a cohort of
ambulatory patients with postvaccination breakthrough SARS-CoV-2 infections with longitudinal
collection of nasal swabs for SARS-CoV-2 viral load quantification, whole-genome sequencing, and Vi load Viral sequencing Viral culture
viral culture. All delta variant infections in our cohort were symptomatic, compared with 6496 of
non-delta variant infections. Symptomatic delta variant breakthrough infections were characterized
by higher initial viral load, Ionger duration of virologic shedding by PCR, greater likelihood of
replication-competent virus at early stages of infection, and longer duration of culturable virus
compared with non-delta variants. The duration of time since vaccination was also correlated

with both duration of PCR positivity and duration of detection of renlication-competent virus. 各 は
Nonetheless, no individuals with symptomatic delta variant infections had renlication-competent ン
Virus by day 10 after symptom onset or 24 hours after resolution of symptoms. These data support
US CDC isolation guidelines as of November 2021, which recommend isolation for 10 days or

until symptom resolution and reinforce the importance of prompt testing and isolation among | 症D
symptomatic individuals with delta breakthrough infections. Additional data are needed to evaluate
these relationships among asymptomatic and more severe delta variant breakthrough infections. | |
ペ Cohort stratified by identification
夫(
of delta Vs non-delta Virus
Oelta variant infections Non-delta variant infections
Median 13.5 days to PCR negative Median 4 days to PCR negative
Median 7 days to culture negative Median 3 days to culture negative
7C7 /カs7g7. 2022:7(2):e155483. https://doi.org/10.1172/jci.insight.155483.
Post-vaccination symptomatic delta variant infections were characterized by significantly longer
duration of PCR positivity and longer isolation of replication-competent virus