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J Glob Health . Duration of SARS-CoV-2 shedding: A systematic review

tetano

Editor, Senior Moderator
J Glob Health


. 2024 Mar 29:14:05005.
doi: 10.7189/jogh.14.05005. Duration of SARS-CoV-2 shedding: A systematic review

Anouk M Oordt-Speets[SUP] 1 [/SUP], Julia R Spinardi[SUP] 2 [/SUP], Carlos F Mendoza[SUP] 3 [/SUP], Jingyan Yang[SUP] 4 [/SUP], Graciela Del Carmen Morales[SUP] 5 [/SUP], Moe H Kyaw[SUP] 6 [/SUP]



Affiliations
Abstract

Background: Positive viral severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cultures indicate shedding of infectious virus and corresponding transmission risk of coronavirus disease 2019 (COVID-19). The research question of this systematic review was: Is there a discernible pattern in the timing of SARS-CoV-2 virus isolation, and what is the proportion of positive and negative results for isolation of SARS-CoV-2 virus with viral culture relative to the onset of clinical symptoms or the day of diagnosis, as indicated by longitudinal studies?
Methods: We systematically searched PubMed and Embase from inception to 16 February 2023 for English-language studies with serial viral culture testing within symptomatic or asymptomatic SARS-CoV-2 infected persons during the post-vaccination period. Outcomes of interest were the daily culture status per study and the overall daily culture positivity rate of SARS-CoV-2. We critically appraised the selected studies using the Newcastle-Ottawa quality assessment scale.
Results: We included 14 viral shedding studies in this systematic review. Positive viral SARS-CoV-2 cultures were detected in samples ranging from 4 days before to 18 days after symptom onset. The daily culture SARS-CoV-2 positivity rate since symptom onset or diagnosis showed a steep decline between day 5 and 9, starting with a peak ranging from 44% to 50% on days -1 to 5, decreasing to 28% on day 7 and 11% on day 9, and finally ranging between 0% and 8% on days 10-17.
Conclusions: Viral shedding peaked within 5 days since symptom onset or diagnosis and the culture positivity rate rapidly declined hereafter. This systematic review provides an overview of current evidence on the daily SARS-CoV-2 culture positivity rates during the post-vaccination period. These findings could be used to estimate the effectiveness of public health control measures, including treatment and preventive strategies, to reduce the spread of COVID-19.


 
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