In vivo kinetics of SARS-CoV-2 infection and its relationship with a person's infectiousness

被引:120
作者
Ke, Ruian [1 ,2 ]
Zitzmann, Carolin [1 ]
Ho, David D. [3 ]
Ribeiro, Ruy M. [1 ]
Perelson, Alan S. [1 ,2 ]
机构
[1] Los Alamos Natl Lab, Theoret Div, Theoret Biol & Biophys Grp, Los Alamos, NM 87545 USA
[2] New Mexico Consortium, Los Alamos, NM 87544 USA
[3] Columbia Univ, Aaron Diamond AIDS Res Ctr, Vagelos Coll Phys & Surg, New York, NY 10032 USA
关键词
SARS-CoV-2; viral kinetics; infectiousness; VIRUS-INFECTION; VIRAL LOAD; INFLUENZA; DYNAMICS; RISK;
D O I
10.1073/pnas.2111477118
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
The within-host viral kinetics of SARS-CoV-2 infection and how they relate to a person's infectiousness are not well understood. This limits our ability to quantify the impact of interventions on viral transmission. Here, we develop viral dynamic models of SARS-CoV-2 infection and fit them to data to estimate key within-host parameters such as the infected cell half-life and the within-host reproductive number. We then develop a model linking viral load (VL) to infectiousness and show a person's infectiousness increases sublinearly with VL and that the logarithm of the VL in the upper respiratory tract is a better surrogate of infectiousness than the VL itself. Using data on VL and the predicted infectiousness, we further incorporated data on antigen and RT-PCR tests and compared their usefulness in detecting infection and preventing transmission. We found that RT-PCR tests perform better than antigen tests assuming equal testing frequency; however, more frequent antigen testing may perform equally well with RT-PCR tests at a lower cost but with many more false-negative tests. Overall, our models provide a quantitative framework for inferring the impact of therapeutics and vaccines that lower VL on the infectiousness of individuals and for evaluating rapid testing strategies.
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页数:9
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