Persistent SARS-CoV-2 RNA Shedding Without Evidence of Infectiousness: A Cohort Study of Individuals With COVID-19.


Journal

The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675

Informations de publication

Date de publication:
28 Oct 2021
Historique:
received: 16 10 2020
accepted: 17 02 2021
pubmed: 3 3 2021
medline: 9 11 2021
entrez: 2 3 2021
Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 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 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 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.

Identifiants

pubmed: 33649773
pii: 6154064
doi: 10.1093/infdis/jiab107
pmc: PMC7989388
doi:

Substances chimiques

RNA, Viral 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1362-1371

Investigateurs

Lindsey M Duca (LM)
Elizabeth Rabold (E)
Radhika Gharpure (R)
Henry Njuguna (H)
Patrick Dawson (P)
Erin E Conners (EE)
Victoria Fields (V)
Phillip Salvatore (P)
Perrine Marcenac (P)
Hannah E Reses (HE)
Mark Fajans (M)
Rebecca L Laws (RL)
Sherry Yin (S)
Dongni Ye (D)
Eric Pevzner (E)
Katherine Battey (K)
Cuc Tran (C)
Michelle O'Hegarty (M)
Jeni Vuong (J)
Rebecca J Chancey (RJ)
Christopher J Gregory (CJ)
Michelle Banks (M)
Jared Rispens (J)
Sandra Lester (S)
Lisa Mills (L)
Alicia Fry (A)
Scott Nabity (S)
Brandi Freeman (B)
Sean Buono (S)

Informations de copyright

Published by Oxford University Press for the Infectious Diseases Society of America 2021.

Auteurs

Daniel Owusu (D)

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Mary A Pomeroy (MA)

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Nathaniel M Lewis (NM)

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Utah Department of Health, Salt Lake City, Utah, USA.

Ashutosh Wadhwa (A)

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Laboratory Leadership Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Anna R Yousaf (AR)

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Brett Whitaker (B)

COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Elizabeth Dietrich (E)

COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Aron J Hall (AJ)

COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Victoria Chu (V)

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Natalie Thornburg (N)

COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Kimberly Christensen (K)

Utah Public Health Laboratory, Taylorsville, Utah, USA.

Tair Kiphibane (T)

Salt Lake County Health Department, Salt Lake City, Utah, USA.

Sarah Willardson (S)

Davis County Health Department, Clearfield, Utah, USA.

Ryan Westergaard (R)

Wisconsin Department of Health Services, Madison, Wisconsin, USA.

Trivikram Dasu (T)

City of Milwaukee Health Department, Milwaukee, Wisconsin, USA.

Ian W Pray (IW)

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Wisconsin Department of Health Services, Madison, Wisconsin, USA.

Sanjib Bhattacharyya (S)

City of Milwaukee Health Department, Milwaukee, Wisconsin, USA.

Angela Dunn (A)

Utah Department of Health, Salt Lake City, Utah, USA.

Jacqueline E Tate (JE)

COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Hannah L Kirking (HL)

COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Almea Matanock (A)

COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

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