Persistent SARS-CoV-2 RNA Shedding Without Evidence of Infectiousness: A Cohort Study of Individuals With COVID-19. (27th February 2021)

• Record Type: Journal Article
• Authors: Owusu, Daniel; Pomeroy, Mary A; Lewis, Nathaniel M; Wadhwa, Ashutosh; Yousaf, Anna R; Whitaker, Brett; Dietrich, Elizabeth; Hall, Aron J; Chu, Victoria; Thornburg, Natalie; Christensen, Kimberly; Kiphibane, Tair; Willardson, Sarah; Westergaard, Ryan; Dasu, Trivikram; Pray, Ian W; Bhattacharyya, Sanjib; Dunn, Angela; Tate, Jacqueline E; Kirking, Hannah L; Matanock, Almea
• Is Part Of: Journal of infectious diseases. Volume 224:Number 8(2021)
• Page Start: 1362
• Page End: 1371
• Publication Date: 2021-02-27
• Subjects: SARS-CoV-2 -- COVID-19 -- viral shedding -- viral culture -- infectivity -- infectious period; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiab107
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: To better understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding and infectivity, we estimated SARS-CoV-2 RNA shedding duration, described participant characteristics associated with the first negative rRT-PCR test (resolution), and determined if replication-competent viruses was recoverable ≥10 days after symptom onset. Methods: We collected serial nasopharyngeal specimens from 109 individuals with rRT-PCR–confirmed COVID-19 in Utah and Wisconsin. We calculated viral RNA shedding resolution probability using the Kaplan-Meier estimator and evaluated characteristics associated with shedding resolution using Cox proportional hazards regression. We attempted viral culture for 35 rRT-PCR–positive nasopharyngeal specimens collected ≥10 days after symptom onset. Results: The likelihood of viral RNA shedding resolution at 10 days after symptom onset was approximately 3%. Time to shedding resolution was shorter among participants aged <18 years (adjusted hazards ratio [aHR], 3.01; 95% confidence interval [CI], 1.6–5.6) and longer among those aged ≥50 years (aHR, 0.50; 95% CI, .3–.9) compared to participants aged 18–49 years. No replication-competent viruses were recovered. Conclusions: Although most patients were positive for SARS-CoV-2 for ≥10 days after symptom onset, our findings suggest that individuals with mild to moderate COVID-19 are unlikely to be infectious ≥10 days after symptom onset. Abstract : The majority of participants with mild to moderate COVID-19 continued to shed SARS-CoV-2 from the nasopharynx ≥10 days after symptom onset. However, we did not recover any replication-competent virus from 35 rRT-PCR–positive nasopharyngeal specimens collected ≥10 days after symptom onset.