{"doi":"10.1172/jci.insight.192228","title":"Virologic characteristics of SARS-CoV-2 infection across evolving Omicron subvariants","abstract":"BACKGROUNDSARS-CoV-2 has evolved subvariants since the emergence of the Omicron variant in 2021. Whether these changes impact viral shedding and transmissibility is not known.METHODSPOSITIVES is a prospective longitudinal cohort of individuals with mild SARS-CoV-2 infection. Ambulatory, immunocompetent participants who did not receive antivirals self-administered 6 anterior nasal swabs over 15 days. Samples were analyzed by qPCR to quantify viral RNA, semiquantitative viral culture to detect shedding of replication-competent virus, and whole-genome sequencing to classify subvariants. Our predictor of interest was Omicron subvariants: BA.1x, BA.2x, BA.4/5x, XBB.x, and JN.x. Outcomes included RNA levels and duration of shedding replication-competent virus. We additionally explored whether symptoms are a valid marker for ending isolation.RESULTSThe median peak nasal SARS-CoV-2 RNA (6.0-6.3 log10 RNA copies/mL), median days to peak RNA (4-5 days), median days to undetectable viral RNA (12-14 days), and median days to negative viral culture (4-8 days) were similar across Omicron subvariants. Number and duration of symptoms were also similar. For all subvariants, a sizeable percentage (range 27.5%-56.0%) shed replication-competent virus after fever resolution and improvement of symptoms.CONCLUSIONDespite ongoing viral evolution, key aspects of viral dynamics of SARS-CoV-2 infection, including the duration of shedding replication-competent virus, have not substantially changed across Omicron subvariants. Replication-competent shedding of these subvariants is detected for a large proportion of people who meet criteria for ending isolation.FUNDINGNIH (U19 AI110818, R01 AI176287, K24 HL166024), the Massachusetts Consortium on Pathogen Readiness, and the Massachusetts General Hospital Department of Medicine.","journal":"JCI Insight","year":2025,"id":546762,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9193,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1166651,"name":"Owen T. Glover","orcid":null,"position":1,"is_corresponding":false},{"id":888772,"name":"Caitlin Marino","orcid":null,"position":2,"is_corresponding":false},{"id":1024780,"name":"Gregory E. Edelstein","orcid":null,"position":3,"is_corresponding":false},{"id":218333,"name":"Manish C. Choudhary","orcid":"0000-0002-3192-7840","position":4,"is_corresponding":false},{"id":218325,"name":"Yijia Li","orcid":"0000-0001-5300-0571","position":5,"is_corresponding":false},{"id":1358728,"name":"Brooke M. Leeman","orcid":null,"position":6,"is_corresponding":false},{"id":259554,"name":"Zahra Reynolds","orcid":"0000-0003-0668-6798","position":7,"is_corresponding":false},{"id":1208171,"name":"Karry Su","orcid":null,"position":8,"is_corresponding":false},{"id":1024781,"name":"Dessie Tien","orcid":null,"position":9,"is_corresponding":false},{"id":1439250,"name":"Chase B. Mandell","orcid":null,"position":10,"is_corresponding":false},{"id":654896,"name":"Eliza Passell","orcid":"0000-0003-3198-6071","position":11,"is_corresponding":false},{"id":1358734,"name":"Andrew Alexandrescu","orcid":null,"position":12,"is_corresponding":false},{"id":1208172,"name":"Emory Abar","orcid":null,"position":13,"is_corresponding":false},{"id":1024071,"name":"Mamadou Barry","orcid":"0009-0005-1458-2528","position":14,"is_corresponding":false},{"id":798429,"name":"Dibya Ghimire","orcid":null,"position":15,"is_corresponding":false},{"id":660762,"name":"Tammy D. Vyas","orcid":null,"position":16,"is_corresponding":false},{"id":284649,"name":"Jatin M. Vyas","orcid":"0000-0002-9985-9565","position":17,"is_corresponding":false},{"id":226714,"name":"Jacob E. Lemieux","orcid":"0000-0002-2758-4005","position":18,"is_corresponding":false},{"id":108340,"name":"Jonathan Z. Li","orcid":"0000-0001-9914-9662","position":19,"is_corresponding":false},{"id":69650,"name":"Mark J. Siedner","orcid":"0000-0003-3506-842X","position":20,"is_corresponding":false},{"id":646796,"name":"Amy K. Barczak","orcid":"0000-0003-3806-2381","position":21,"is_corresponding":false},{"id":108357,"name":"Julie Boucau","orcid":"0000-0001-6731-7238","position":0,"is_corresponding":true}],"reference_count":23,"raw_metadata":null,"created_at":"2026-07-19T02:53:36.567932Z","pmid":"40924669","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}