Abstract
We aimed to assess the duration of nasopharyngeal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA persistence in adults self-confined at home after acute infection; and to identify the associations of SARS-CoV-2 persistence with respiratory virus co-detection and infection transmission. A cross-sectional intra-household study was conducted in metropolitan Barcelona (Spain) during the time period of April to June 2020. Every adult who was the first family member reported as SARS-CoV-2-positive by reverse transcription polymerase chain reaction (RT-PCR) as well as their household child contacts had nasopharyngeal swabs tested by a targeted SARS-CoV-2 RT-PCR and a multiplex viral respiratory panel after a 15 day minimum time lag. Four-hundred and four households (404 adults and 708 children) were enrolled. SARS-CoV-2 RNA was detected in 137 (33.9%) adults and 84 (11.9%) children. Rhinovirus/Enterovirus (RV/EV) was commonly found (83.3%) in co-infection with SARS-CoV-2 in adults. The mean duration of SARS-CoV-2 RNA presence in adults’ nasopharynx was 52 days (range 26–83 days). The persistence of SARS-CoV-2 was significantly associated with RV/EV co-infection (adjusted odds ratio (aOR) 9.31; 95% CI 2.57–33.80) and SARS-CoV-2 detection in child contacts (aOR 2.08; 95% CI 1.24–3.51). Prolonged nasopharyngeal SARS-CoV-2 RNA persistence beyond the acute infection phase was frequent in adults quarantined at home during the first epidemic wave; which was associated with RV/EV co-infection and could enhance intra-household infection transmission.
Highlights
The infectious coronavirus disease 2019 (COVID-19) caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had devastating public health consequences globally since it first emerged in Wuhan, China in December 2019 [1]
Participant adults recovering or completely recovered from COVID-19 had tested positive for SARS-CoV-2 RNA detection in a nasopharyngeal swab at least 15 days before their household was visited for sample collection
All family members were tested by rapid immunochromatographic lateral flow assay (LFA) at the household visit, whereas only adults that gave their consent had venous blood extracted for subsequent enzyme-linked immunosorbent assay (ELISA) at the laboratory of the study site
Summary
The infectious coronavirus disease 2019 (COVID-19) caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had devastating public health consequences globally since it first emerged in Wuhan, China in December 2019 [1]. Spain was one of the most strongly affected countries, with over 3.7 million cases and around 80,000 of deaths as of June 2021 [2]. SARS-CoV-2 RNA detection by reverse transcription polymerase chain reaction (RTPCR) is an accurate method that is widely used to diagnose and monitor COVID-19 [4]. Diverse case series studies have reported that SARS-CoV-2 RNA remains detectable in upper respiratory samples for between 11 and 20 days since symptom onset [5,6]. The impact of virus persistence on disease transmissibility remains incompletely understood [7]
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