TY - JOUR
T1 - Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19)
AU - van Kampen, Jeroen
AU - van de Vijver, David
AU - Fraaij, Pieter
AU - Haagmans, Bart
AU - Lamers, Mart
AU - Okba, Nisreen
AU - van den Akker, Johan
AU - Endeman, Rik
AU - Gommers, Diederik
AU - Cornelissen, Jan
AU - Hoek, R.A.S.
AU - van der Eerden, Menno
AU - Hesselink, Dennis
AU - Metselaar, Herold
AU - Verbon, Annelies
AU - de Steenwinkel, Jurriaan
AU - Aron, GI (Georgina)
AU - van Gorp, Eric
AU - van Boheemen, Sander
AU - Kreeft - Voermans, Jolanda
AU - Boucher, Charles
AU - Molenkamp, Richard
AU - Koopmans, Marion
AU - Geurts van Kessel, Corine
AU - Baltissen - van der Eijk, Annemiek
N1 - Funding Information:
Role of the funding source. This work partially was funded through EU COVID-19 grant RECOVER 101003589. The study sponsors were involved neither in the study design, the collection, analysis and interpretation of the data, writing of the report, nor in the decision to submit the paper for publication. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/1/11
Y1 - 2021/1/11
N2 - 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 log10 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.
AB - 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 log10 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.
UR - http://www.scopus.com/inward/record.url?scp=85099202160&partnerID=8YFLogxK
U2 - 10.1038/s41467-020-20568-4
DO - 10.1038/s41467-020-20568-4
M3 - Article
C2 - 33431879
SN - 2041-1723
VL - 12
JO - Nature Communications
JF - Nature Communications
IS - 1
M1 - 267
ER -