Elsevier

Journal of Infection

Volume 81, Issue 6, December 2020, Pages 847-856
Journal of Infection

Review
The duration of infectiousness of individuals infected with SARS-CoV-2

https://doi.org/10.1016/j.jinf.2020.10.009Get rights and content

Highlights

  • 15 studies were included - 13 SARS-CoV-2 culture and 2 contact tracing studies.

  • Mild-to-moderate COVID-19 patients highly unlikely to be infectious after day 10.

  • Immunocompromised and severe-to-critical patients may be infectious for >10 days.

  • This evidence may be used to inform duration of isolation guidance.

Summary

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.

Keywords

SARS-CoV-2
COVID-19
Isolation
Infectiousness
Review
Coronavirus
RNA
Virus culture
Contact tracing

Cited by (0)

1

Both authors contributed equally.

2

Both authors are co-senior authors.

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