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
PY - 2021
Y1 - 2021
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.
U2 - 10.1038/s41467-020-20568-4
DO - 10.1038/s41467-020-20568-4
M3 - Article
VL - 12
JO - Nature Communications
JF - Nature Communications
SN - 2041-1723
IS - 1
M1 - 267
ER -