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Alpha, Delta, and Omicron patients may exhale more viruses

A study today from researchers at the University of Maryland determined that patients infected with COVID-19 variants Alpha, Delta, and Omicron--including those fully vaccinated and boosted--shed significantly more viral RNA copies into exhaled breath aerosols than patients infected with ancestral strains and other variants.

The study appears in Clinical Infectious Diseases and adds to evidence of increased transmissibility of the Alpha, Delta, and Omicron variants. The study used 30-minute respiratory samples collected via a Gesundheit-II exhaled breath aerosol sampler from 93 participants who had confirmed COVID-19 infections. Of those, 32 were fully vaccinated and 20 boosted. The participants were tested from June 2020 through March 2022.

According to the authors, 4 Alpha, 3 Delta, and 29 Omicron patients shed significantly more viral RNA copies into exhaled breath aerosols than the 57 people infected with ancestral strains and variants.

The increase in viral shedding may have been at least partly due to participant behavior while in the Gesundheit machine. The authors said Delta and Omicron patients coughed more frequently than those infected with Alpha, ancestral strains, and other variants. Omicron patients also generally reported more upper and lower respiratory symptoms than the other volunteers.

"These data indicate that a characteristic of highly transmissible variants is a high rate of viral shedding into aerosols," the authors concluded. "This evidence for convergent evolution of increased viral aerosol shedding is consistent with a dominant role for airborne transmission (inhalation of viral aerosols regardless of distance that the aerosol traversed) in the spread of COVID-19."

[Source: CIDRAP News, University of Minnesota, 26Oct22]

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