ArticlemedRxiv : the preprint server for health sciences2025
Peak Nasal SARS-CoV-2 and Influenza Viral Loads Relative to Symptom Onset, 2022-2025: Impact of Vaccination and Implications for Multiplexed Testing.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: We previously reported that nasal SARS-CoV-2 viral loads (VL) peaked around the fourth day of symptoms in highly immune adults sampled April 2022 - April 2023, while influenza A VL peaked soon after symptom onset. We hypothesized that SARS-CoV-2 kinetics may have changed due to reduced COVID-19 incidence and altered vaccination patterns. Understanding how viral kinetics evolve over time is essential to inform testing strategies. Methods: Participants with symptomatic upper respiratory infection were recruited at testing centers in Georgia April 14, 2023-April 11, 2025. Participants reported date of symptom onset and vaccination history. A nasal swab was tested on the Xpert Results: 552 adults (≧ 16 years) and 60 children (<16y) were SARS-CoV-2-positive; lowest median Ct values (highest VL) were observed on the 2 Conclusions: In 2023-25, median SARS-CoV-2 VL peaked earlier relative to symptom onset compared to a highly immune 2022-23 cohort. More recent vaccination correlated with delayed peak VL, suggesting more robust immunity correlates with earlier symptom onset relative to peak. Median influenza A VL were highest at symptom onset, versus 4 days into symptoms for influenza B. These findings can inform use of multiplexed antigen tests amidst changing immunity and viral circulation patterns.
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