Prolonged shedding of severe acute respiratory syndrome coronavirus 2 in patients with COVID-19

Q Li, XS Zheng, XR Shen, HR Si, X Wang… - Emerging Microbes & …, 2020 - Taylor & Francis
Q Li, XS Zheng, XR Shen, HR Si, X Wang, Q Wang, B Li, W Zhang, Y Zhu, RD Jiang, K Zhao…
Emerging Microbes & Infections, 2020Taylor & Francis
Following acute infection, individuals COVID-19 may still shed SARS-CoV-2 RNA. However,
limited information is available regarding the active shedding period or whether infectious
virus is also shed. Here, we monitored the clinical characteristics and virological features of
38 patients with COVID-19 (long-term carriers) who recovered from the acute disease, but
still shed viral RNA for over 3 months. The median carrying history of the long-term carriers
was 92 days after the first admission, and the longest carrying history was 118 days …
Abstract
Following acute infection, individuals COVID-19 may still shed SARS-CoV-2 RNA. However, limited information is available regarding the active shedding period or whether infectious virus is also shed. Here, we monitored the clinical characteristics and virological features of 38 patients with COVID-19 (long-term carriers) who recovered from the acute disease, but still shed viral RNA for over 3 months. The median carrying history of the long-term carriers was 92 days after the first admission, and the longest carrying history was 118 days. Negative-positive viral RNA-shedding fluctuations were observed. Long-term carriers were mostly elderly people with a history of mild infection. Infectious SARS-CoV-2 was isolated from the sputum, where high level viral RNA was found. All nine full-length genomes of samples obtained in March-April 2020 matched early viral clades circulating in January-February 2020, suggesting that these patients persistently carried SARS-CoV-2 and were not re-infected. IgM and IgG antibodies and neutralizing-antibody profiles were similar between long-term carriers and recovered patients with similar disease courses. In summary, although patients with COVID-19 generated neutralizing antibodies, they may still shed infectious SARS-CoV-2 for over 3 months. These data imply that patients should be monitored after discharge to control future outbreaks.
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