Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19)

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 o...

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Published in:Nature communications Vol. 12; no. 1; pp. 267 - 6
Main Authors: van Kampen, Jeroen J. A., van de Vijver, David A. M. C., Fraaij, Pieter L. A., Haagmans, Bart L., Lamers, Mart M., Okba, Nisreen, van den Akker, Johannes P. C., Endeman, Henrik, Gommers, Diederik A. M. P. J., Cornelissen, Jan J., Hoek, Rogier A. S., van der Eerden, Menno M., Hesselink, Dennis A., Metselaar, Herold J., Verbon, Annelies, de Steenwinkel, Jurriaan E. M., Aron, Georgina I., van Gorp, Eric C. M., van Boheemen, Sander, Voermans, Jolanda C., Boucher, Charles A. B., Molenkamp, Richard, Koopmans, Marion P. G., Geurtsvankessel, Corine, van der Eijk, Annemiek A.
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 11.01.2021
Nature Publishing Group
Nature Portfolio
Subjects:
13/1
13/106
45/88
631/326/596/4130
692/308/575
692/699/255/2514
Accident prevention
Aged
Antibodies
Confidence intervals
Coronaviruses
COVID-19
COVID-19 - diagnosis
COVID-19 - virology
COVID-19 Testing
Determinants
Disease control
Female
Humanities and Social Sciences
Humans
Male
Middle Aged
multidisciplinary
Multivariate Analysis
Odds Ratio
Respiratory System - virology
Respiratory tract
Ribonucleic acid
RNA
RNA, Viral
SARS-CoV-2
Science
Science (multidisciplinary)
Severe acute respiratory syndrome coronavirus 2
Signs and symptoms
Viral diseases
Viral Load
Virus Shedding
Viruses
ISSN:2041-1723, 2041-1723
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Summary: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 10 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. Duration of infectious SARS-CoV-2 shedding is an important measure for improved disease control. Here, the authors use virus cultures of respiratory tract samples from COVID-19 patients and observe a median shedding duration of 8 days and a drop below 5% after 15,2 days post onset of symptoms.
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ISSN:2041-1723
2041-1723
DOI:10.1038/s41467-020-20568-4