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

被引：70

作者：

Owusu, Daniel ^{[1
,2
]}

Pomeroy, Mary A. ^{[1
,2
]}

Lewis, Nathaniel M. ^{[1
,3
]}

Wadhwa, Ashutosh ^{[1
,4
]}

Yousaf, Anna R. ^{[1
,2
]}

Whitaker, Brett ^{[2
]}

Dietrich, Elizabeth ^{[2
]}

Hall, Aron J. ^{[2
]}

Chu, Victoria ^{[1
,2
]}

Thornburg, Natalie ^{[2
]}

Christensen, Kimberly ^{[5
]}

Kiphibane, Tair ^{[6
]}

Willardson, Sarah ^{[7
]}

Westergaard, Ryan ^{[8
]}

Dasu, Trivikram ^{[9
]}

Pray, Ian W. ^{[1
,8
]}

Bhattacharyya, Sanjib ^{[9
]}

Dunn, Angela ^{[3
]}

Tate, Jacqueline E. ^{[2
]}

Kirking, Hannah L. ^{[2
]}

Matanock, Almea ^{[2
]}

机构：

[1] Ctr Dis Control & Prevent, Epidem Intelligence Serv, Atlanta, GA 30333 USA

[2] Ctr Dis Control & Prevent, COVID 19 Response Team, Atlanta, GA 30333 USA

[3] Utah Dept Hlth, Salt Lake City, UT 84116 USA

[4] Ctr Dis Control & Prevent, Lab Leadership Serv, Atlanta, GA 30333 USA

[5] Utah Publ Hlth Lab, Taylorsville, UT USA

[6] Salt Lake Cty Hlth Dept, Salt Lake City, UT USA

[7] Davis Cty Hlth Dept, Clearfield, UT USA

[8] Wisconsin Dept Hlth Serv, Madison, WI USA

[9] City Milwaukee Hlth Dept, Milwaukee, WI USA

来源：

JOURNAL OF INFECTIOUS DISEASES | 2021年 / 224卷 / 08期

关键词：

SARS-CoV-2; COVID-19; viral shedding; viral culture; infectivity; infectious period; VIRAL LOAD;

D O I：

10.1093/infdis/jiab107

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

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.

引用

页码：1362 / 1371

页数：10