Persistent SARS-CoV-2 RNA shedding without evidence of infectiousness: a cohort study of individuals with COVID-19
The Journal of Infectious Diseases, 2021•academic.oup.com
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 …
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 …
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.
Oxford University Press