Prolonged shedding of severe acute respiratory syndrome coronavirus 2 in patients with COVID-19. Issue 1 (1st January 2020)

• Record Type: Journal Article
• Authors: Li, Qian; Zheng, Xiao-Shuang; Shen, Xu-Rui; Si, Hao-Rui; Wang, Xi; Wang, Qi; Li, Bei; Zhang, Wei; Zhu, Yan; Jiang, Ren-Di; Zhao, Kai; Wang, Hui; Shi, Zheng-Li; Zhang, Hui-Lan; Du, Rong-Hui; Zhou, Peng
• Is Part Of: Emerging microbes & infections. Volume 9:Issue 1(2020)
• Page Start: 2571
• Page End: 2577
• Publication Date: 2020-01-01
• Subjects: SARS-CoV-2 -- COVID-19 -- long-term carrier -- prolonged shedding -- transmission risk; Medical microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.9041
• DOI: 10.1080/22221751.2020.1852058
• Languages: English
• ISSNs: 2222-1751

Abstract

ABSTRACT: Following acute infection, individuals COVID-19 may still shed SARS-CoV-2 RNA. However, limited information is available regarding the active shedding period or whether infectious virus is also shed. Here, we monitored the clinical characteristics and virological features of 38 patients with COVID-19 (long-term carriers) who recovered from the acute disease, but still shed viral RNA for over 3 months. The median carrying history of the long-term carriers was 92 days after the first admission, and the longest carrying history was 118 days. Negative-positive viral RNA-shedding fluctuations were observed. Long-term carriers were mostly elderly people with a history of mild infection. Infectious SARS-CoV-2 was isolated from the sputum, where high level viral RNA was found. All nine full-length genomes of samples obtained in March–April 2020 matched early viral clades circulating in January–February 2020, suggesting that these patients persistently carried SARS-CoV-2 and were not re-infected. IgM and IgG antibodies and neutralizing-antibody profiles were similar between long-term carriers and recovered patients with similar disease courses. In summary, although patients with COVID-19 generated neutralizing antibodies, they may still shed infectious SARS-CoV-2 for over 3 months. These data imply that patients should be monitored after discharge to control future outbreaks.