What is the viral rebound in untreated COVID-19 infections? medrxivpreprint harvardmed ViralRebound SymptomRebound COVID19 SARSCoV2 Coronavirus
By Bhavana KunkalikarAug 4 2022Reviewed by Aimee Molineux In a recent study posted to the medRxiv* preprint server, researchers assessed the coronavirus disease 2019 rebound in untreated COVID-19 infections.
The team enrolled adults aged 18 years and above from the ACTIV-2/A5401 platform trial performed for outpatients having mild to moderate COVID-19. Analysis of viral rebounds was restricted to subjects who participated in the placebo arm of the ACTIV-2/A5401 phase 2 studies and were treated with 700mg bamlanivimab, 7000mg bamlanivimab, and amubarvimab plus romlusevimab monoclonal antibodies. The team collected daily self-reported symptoms for the initial 28 days.
The team also collected daily anterior nasal swabs from the day of study entry to day 14 and day 28. Additionally, the bamlanivimab participants provided another sample for viral loading testing on day 21. SARS-CoV-2 ribonucleic acid levels were estimated from the AN samples. A sample displayed viral rebound if it had a 0.5 log10 or higher increase in SARS-CoV-2 RNA levels in AN samples at a follow-up time point per the baseline.
Furthermore, participants with viral RNA rebounds were older than those with no RNA rebound. The team also estimated the frequencies related to high levels of nasal RNA rebound having a 5.0 log10 minimum rebound threshold, and 5.3% of the participants satisfied this definition of virus rebound. The primary analysis also showed that 12% and 6.9% of the participants displayed viral rebound rates estimated per the minimum threshold of 0.3 log10 or more and 0.5 log10 RNA copies per ml, respectively.
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