Inferred duration of infectious period of SARS-CoV-2: rapid scoping review and analysis of available evidence for asymptomatic and symptomatic COVID-19 cases

ObjectivesOur objective was to review the literature on the inferred duration of the infectious period of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, and provide an overview of the variation depending on the methodological approach.DesignRapid scoping revi...

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Vydané v:BMJ open Ročník 10; číslo 8; s. e039856
Hlavní autori: Byrne, Andrew William, McEvoy, David, Collins, Aine B, Hunt, Kevin, Casey, Miriam, Barber, Ann, Butler, Francis, Griffin, John, Lane, Elizabeth A, McAloon, Conor, O'Brien, Kirsty, Wall, Patrick, Walsh, Kieran A, More, Simon J
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England British Medical Journal Publishing Group 05.08.2020
BMJ Publishing Group LTD
BMJ Publishing Group
Edícia:Original research
Predmet:
Adult
Asymptomatic
Betacoronavirus
Child
Communicable Diseases - complications
Communicable Diseases - mortality
Communicable Diseases - transmission
Communicable Diseases - virology
Contact tracing
Content analysis
Coronavirus Infections - complications
Coronavirus Infections - mortality
Coronavirus Infections - transmission
Coronavirus Infections - virology
Coronaviruses
COVID-19
Diagnostic tests
Disease transmission
Epidemiology
Fatalities
Global Health
Hospitalization
Humans
Infections
infectious diseases
Mathematical models
Pandemics
Pneumonia, Viral - complications
Pneumonia, Viral - mortality
Pneumonia, Viral - transmission
Pneumonia, Viral - virology
Polymerase Chain Reaction
public health
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Viral Load
virology
epidemiology
virology
public health
infectious diseases
ISSN:2044-6055, 2044-6055
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Shrnutí:ObjectivesOur objective was to review the literature on the inferred duration of the infectious period of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, and provide an overview of the variation depending on the methodological approach.DesignRapid scoping review. Literature review with fixed search terms, up to 1 April 2020. Central tendency and variation of the parameter estimates for infectious period in (A) asymptomatic and (B) symptomatic cases from (1) virological studies (repeated testing), (2) tracing studies and (3) modelling studies were gathered. Narrative review of viral dynamics.Information sourcesSearch strategies developed and the following searched: PubMed, Google Scholar, MedRxiv and BioRxiv. Additionally, the Health Information Quality Authority (Ireland) viral load synthesis was used, which screened literature from PubMed, Embase, ScienceDirect, NHS evidence, Cochrane, medRxiv and bioRxiv, and HRB open databases.ResultsThere was substantial variation in the estimates, and how infectious period was inferred. One study provided approximate median infectious period for asymptomatic cases of 6.5–9.5 days. Median presymptomatic infectious period across studies varied over <1–4 days. Estimated mean time from symptom onset to two negative RT-PCR tests was 13.4 days (95% CI 10.9 to 15.8) but was shorter when studies included children or less severe cases. Estimated mean duration from symptom onset to hospital discharge or death (potential maximal infectious period) was 18.1 days (95% CI 15.1 to 21.0); time to discharge was on average 4 days shorter than time to death. Viral dynamic data and model infectious parameters were often shorter than repeated diagnostic data.ConclusionsThere are limitations of inferring infectiousness from repeated diagnosis, viral loads and viral replication data alone and also potential patient recall bias relevant to estimating exposure and symptom onset times. Despite this, available data provide a preliminary evidence base to inform models of central tendency for key parameters and variation for exploring parameter space and sensitivity analysis.
Bibliografia:Original research
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ObjectType-Literature Review-3
ObjectType-Review-3
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ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2020-039856