Journal
JOURNAL OF INFECTION
Volume 81, Issue 6, Pages 847-856Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2020.10.009
Keywords
SARS-CoV-2; COVID-19; Isolation; Infectiousness; Review; Coronavirus; RNA; Virus culture; Contact tracing
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Funding
- Health Research Board [HRB-CICER-2016-1871]
- Health Research Board (HRB) [HRB-CICER-2016-1871] Funding Source: Health Research Board (HRB)
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Objectives: To summarise the evidence on the duration of infectiousness of individuals in whom SARS-CoV-2 ribonucleic acid is detected. Methods: A rapid review was undertaken in PubMed, Europe PubMed Central and EMBASE from 1 January 2020 to 26 August 2020. Results: We identified 15 relevant studies, including 13 virus culture and 2 contact tracing studies. For 5 virus culture studies, the last day on which SARS-CoV-2 was isolated occurred within 10 days of symptom onset. For another 5 studies, SARS-CoV-2 was isolated beyond day 10 for approximately 3% of included patients. The remaining 3 virus culture studies included patients with severe or critical disease; SARS-CoV-2 was isolated up to day 32 in one study. Two studies identified immunocompromised patients from whom SARS-CoV-2 was isolated for up to 20 days. Both contact tracing studies, when close contacts were first exposed greater than 5 days after symptom onset in the index case, found no evidence of laboratory-confirmed onward transmission of SARS-CoV-2. Conclusion: COVID-19 patients with mild-to-moderate illness are highly unlikely to be infectious beyond 10 days of symptoms. However, evidence from a limited number of studies indicates that patients with severe-to-critical illness or who are immunocompromised, may shed infectious virus for longer. (c) 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
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