Abstract
IntroductionStandard testing for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is based on RT-PCR tests, but detection of viral genetic material alone does not indicate ongoing infectious potential. The ability to isolate whole virus represents a better proxy for infectivity.AimThe objective of this study was to gain an understanding of the current literature and compare the reported periods of positive SARS-CoV-2 detection from studies that conducted RT-PCR testing in addition to experiments isolating whole virus.MethodsUsing a rapid review approach, studies reporting empirical data on the duration of positive RT-PCR results and/or successful viral isolation following SARS-CoV-2 infection in humans were identified through searches of peer-reviewed and pre-print health sciences literature. Articles were screened for relevance, then data were extracted, analysed, and synthesised.ResultsOf the 160 studies included for qualitative analysis, 84% (n = 135) investigated duration of positive RT-PCR tests only, 5% (n = 8) investigated duration of successful viral isolations, while 11% (n = 17) included measurements on both. There was significant heterogeneity in reported data. There was a prolonged time to viral clearance when deduced from RT-PCR tests compared with viral isolations (median: 26 vs 9 days).DiscussionFindings from this review support a minimum 10-day period of isolation but certain cases where virus was isolated after 10 days were identified. Given the extended time to viral clearance from RT-PCR tests, future research should ensure standard reporting of RT-PCR protocols and results to help inform testing policies aimed at clearance from isolation.
Highlights
Standard testing for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is based on reverse transcription-PCR (RT-PCR) tests, but detection of viral genetic material alone does not indicate ongoing infectious potential
Numerous studies have been conducted to date to address this question; the literature has been predominantly represented by studies using methods based on reverse transcription-PCR (RT-PCR) tests
The findings from these reviews have drawn consistent conclusions that align with previously recommended isolation strategies [8]: overall, infectious potential appears to be greatly reduced by day 10 following symptom onset of coronavirus disease (COVID-19) [2,7,9]
Summary
Standard testing for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is based on RT-PCR tests, but detection of viral genetic material alone does not indicate ongoing infectious potential. Methods: Using a rapid review approach, studies reporting empirical data on the duration of positive RT-PCR results and/or successful viral isolation following SARS-CoV-2 infection in humans were identified through searches of peer-reviewed and preprint health sciences literature. While fewer studies have been conducted that have successfully isolated and cultured live virus, results from this literature have contributed to a number of reviews [2-7] The findings from these reviews have drawn consistent conclusions that align with previously recommended isolation strategies [8]: overall, infectious potential appears to be greatly reduced by day 10 following symptom onset of coronavirus disease (COVID-19) [2,7,9]
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