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Oxford University Press - PMC COVID-19 Collection logoLink to Oxford University Press - PMC COVID-19 Collection
. 2021 Feb 15:jiab097. doi: 10.1093/infdis/jiab097

Viral load of SARS-CoV-2 in adults during the first and second wave of COVID-19 pandemic in Houston, TX: the potential of the super-spreader

Vasanthi Avadhanula 1, Erin G Nicholson 1,2, Laura Ferlic-Stark 1, Felipe-Andres Piedra 1, Brittani N Blunck 1, Sonia Fragoso 1, Nanette L Bond 1, Patricia L Santarcangelo 1, Xunyan Ye 1, Trevor J McBride 1, Letisha O Aideyan 1, Kirtida D Patel 1, Lauren Maurer 1, Laura S Angelo 1, Pedro A Piedra 1,2,
PMCID: PMC7928726  PMID: 33585934

Abstract

Background

During the COVID-19 pandemic, a minority of index cases are associated with a majority of secondary cases suggesting that super-spreaders could drive the pandemic. We identified a phenotype in individuals with extremely high viral load who could act as super-spreaders.

Methods

Data were analyzed from individuals tested for SARS-CoV-2 from March 18 through August 15, 2020. Outcomes were compared using contingency table and quantile regression to test the equality of medians between the pandemic waves and by viral load groups.

Results

Of the 11,564 samples tested, 1,319 (11.4%) were positive for SARS-CoV-2. An increase in weekly median viral load occurred in the second wave of the SARS-CoV2 pandemic. This population was more likely to be women, outpatients, symptomatic and have an extremely high or high viral load. In patients with multiple RT-PCR positive tests, the duration of viral shedding was comparable between individuals with asymptomatic/mild and mild/moderate illness severity.

Conclusions

We detected a small group of individuals with extremely high SARS-CoV-2 viral load with mild illness. We believe that these individuals’ characteristics could be consistent with the super-spreader phenomenon and that greater awareness of the social dynamics of these individuals is needed to understand the spread of SARS-CoV-2.

Keywords: SARS-CoV-2, super-spreader, extremely high viral load, viral load kinetics, cycle threshold


Articles from The Journal of Infectious Diseases are provided here courtesy of Oxford University Press

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