HIV Working Group

Carlee Moser, Ph.D.
Senior Research Scientist, Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health

“Predictors of SARS-CoV-2 RNA from nasopharyngeal swabs and concordance with other compartments in non-hospitalized adults with mild to moderate COVID-19, an Exploratory Analysis of ACTIV-2”

ABSTRACT: Identifying characteristics associated with SARS-CoV-2 RNA shedding may be useful to understand viral compartmentalization, disease pathogenesis, and risks for viral transmission. Participants (n=537) enrolled August 2020 to February 2021 in ACTIV-2/A5401, a placebo-controlled platform trial evaluating investigational therapies for mild-to-moderate COVID-19, and underwent quantitative SARS-CoV-2 RNA testing on nasopharyngeal and anterior nasal swabs, oral wash/saliva, and plasma at entry and post-entry. Concordance of RNA levels (copies/mL) across compartments was assessed and predictors of nasopharyngeal RNA levels and changes were evaluated with censored linear regression models. We observed SARS-CoV-2 RNA shedding was concordant across compartments. Age was strongly associated with viral shedding and males had slower viral clearance than females, which could explain sex differences in COVID-related outcomes.