• Vasanthi Avadhanula, Erin G Nicholson, Laura Ferlic-Stark, Felipe-Andres Piedra, Brittani N Blunck, Sonia Fragoso, Nanette L Bond, Patricia L Santarcangelo, Xunyan Ye, Trevor J McBride, Letisha O Aideyan, Kirtida D Patel, Lauren Maurer, Laura S Angelo, and Pedro A Piedra.
• Department of Molecular Virology and Microbiology, Houston, Texas, USA.
• J. Infect. Dis. 2021 May 20; 223 (9): 1528-1537.

BackgroundDuring the coronavirus disease 2019 pandemic, a minority of index cases are associated with a majority of secondary cases suggesting that superspreaders could drive the pandemic. We identified a phenotype in individuals with extremely high viral load who could act as superspreaders.MethodsData were analyzed from individuals tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from 18 March through 15 August 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.ResultsOf the 11 564 samples tested, 1319 (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, and symptomatic and to have an extremely high or high viral load. In patients with multiple reverse-transcription polymerase chain reaction-positive test results, the durations of viral shedding were comparable between individuals with asymptomatic/mild and mild/moderate illness severity.ConclusionsWe detected a small group of individuals with extremely high SARS-CoV-2 viral loads and mild illness. We believe that these individuals' characteristics could be consistent with the superspreader phenomenon and that greater awareness of the social dynamics of these individuals is needed to understand the spread of SARS-CoV-2.© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

26 keywords...

hide…