tetano
Editor, Senior Moderator
Nat Commun
. 2021 Jan 11;12(1):267.
doi: 10.1038/s41467-020-20568-4.
Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19)
Jeroen J A van Kampen[SUP] 1 [/SUP], David A M C van de Vijver[SUP] 2 [/SUP], Pieter L A Fraaij[SUP] 2 3 [/SUP], Bart L Haagmans[SUP] 2 [/SUP], Mart M Lamers[SUP] 2 [/SUP], Nisreen Okba[SUP] 2 [/SUP], Johannes P C van den Akker[SUP] 4 [/SUP], Henrik Endeman[SUP] 4 [/SUP], Diederik A M P J Gommers[SUP] 4 [/SUP], Jan J Cornelissen[SUP] 5 [/SUP], Rogier A S Hoek[SUP] 6 7 [/SUP], Menno M van der Eerden[SUP] 6 [/SUP], Dennis A Hesselink[SUP] 7 8 [/SUP], Herold J Metselaar[SUP] 7 9 [/SUP], Annelies Verbon[SUP] 10 [/SUP], Jurriaan E M de Steenwinkel[SUP] 10 [/SUP], Georgina I Aron[SUP] 2 [/SUP], Eric C M van Gorp[SUP] 2 [/SUP], Sander van Boheemen[SUP] 2 [/SUP], Jolanda C Voermans[SUP] 2 [/SUP], Charles A B Boucher[SUP] 2 [/SUP], Richard Molenkamp[SUP] 2 [/SUP], Marion P G Koopmans[SUP] 2 [/SUP], Corine Geurtsvankessel[SUP] 2 [/SUP], Annemiek A van der Eijk[SUP] 2 [/SUP]
Affiliations
Abstract
Key questions in COVID-19 are the duration and determinants of infectious virus shedding. Here, we report that infectious virus shedding is detected by virus cultures in 23 of the 129 patients (17.8%) hospitalized with COVID-19. The median duration of shedding infectious virus is 8 days post onset of symptoms (IQR 5-11) and drops below 5% after 15.2 days post onset of symptoms (95% confidence interval (CI) 13.4-17.2). Multivariate analyses identify viral loads above 7 log[SUB]10[/SUB] RNA copies/mL (odds ratio [OR] of 14.7 (CI 3.57-58.1; p < 0.001) as independently associated with isolation of infectious SARS-CoV-2 from the respiratory tract. A serum neutralizing antibody titre of at least 1:20 (OR of 0.01 (CI 0.003-0.08; p < 0.001) is independently associated with non-infectious SARS-CoV-2. We conclude that quantitative viral RNA load assays and serological assays could be used in test-based strategies to discontinue or de-escalate infection prevention and control precautions.
. 2021 Jan 11;12(1):267.
doi: 10.1038/s41467-020-20568-4.
Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19)
Jeroen J A van Kampen[SUP] 1 [/SUP], David A M C van de Vijver[SUP] 2 [/SUP], Pieter L A Fraaij[SUP] 2 3 [/SUP], Bart L Haagmans[SUP] 2 [/SUP], Mart M Lamers[SUP] 2 [/SUP], Nisreen Okba[SUP] 2 [/SUP], Johannes P C van den Akker[SUP] 4 [/SUP], Henrik Endeman[SUP] 4 [/SUP], Diederik A M P J Gommers[SUP] 4 [/SUP], Jan J Cornelissen[SUP] 5 [/SUP], Rogier A S Hoek[SUP] 6 7 [/SUP], Menno M van der Eerden[SUP] 6 [/SUP], Dennis A Hesselink[SUP] 7 8 [/SUP], Herold J Metselaar[SUP] 7 9 [/SUP], Annelies Verbon[SUP] 10 [/SUP], Jurriaan E M de Steenwinkel[SUP] 10 [/SUP], Georgina I Aron[SUP] 2 [/SUP], Eric C M van Gorp[SUP] 2 [/SUP], Sander van Boheemen[SUP] 2 [/SUP], Jolanda C Voermans[SUP] 2 [/SUP], Charles A B Boucher[SUP] 2 [/SUP], Richard Molenkamp[SUP] 2 [/SUP], Marion P G Koopmans[SUP] 2 [/SUP], Corine Geurtsvankessel[SUP] 2 [/SUP], Annemiek A van der Eijk[SUP] 2 [/SUP]
Affiliations
- PMID: 33431879
- DOI: 10.1038/s41467-020-20568-4
Abstract
Key questions in COVID-19 are the duration and determinants of infectious virus shedding. Here, we report that infectious virus shedding is detected by virus cultures in 23 of the 129 patients (17.8%) hospitalized with COVID-19. The median duration of shedding infectious virus is 8 days post onset of symptoms (IQR 5-11) and drops below 5% after 15.2 days post onset of symptoms (95% confidence interval (CI) 13.4-17.2). Multivariate analyses identify viral loads above 7 log[SUB]10[/SUB] RNA copies/mL (odds ratio [OR] of 14.7 (CI 3.57-58.1; p < 0.001) as independently associated with isolation of infectious SARS-CoV-2 from the respiratory tract. A serum neutralizing antibody titre of at least 1:20 (OR of 0.01 (CI 0.003-0.08; p < 0.001) is independently associated with non-infectious SARS-CoV-2. We conclude that quantitative viral RNA load assays and serological assays could be used in test-based strategies to discontinue or de-escalate infection prevention and control precautions.