• Daniel Owusu, Mary A Pomeroy, Nathaniel M Lewis, Ashutosh Wadhwa, Anna R Yousaf, Brett Whitaker, Elizabeth Dietrich, Aron J Hall, Victoria Chu, Natalie Thornburg, Kimberly Christensen, Tair Kiphibane, Sarah Willardson, Ryan Westergaard, Trivikram Dasu, Ian W Pray, Sanjib Bhattacharyya, Angela Dunn, Jacqueline E Tate, Hannah L Kirking, Almea Matanock, and Household Transmission Study Team .
• Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
• J. Infect. Dis. 2021 Oct 28; 224 (8): 1362-1371.

BackgroundTo better understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding and infectivity, we estimated SARS-CoV-2 RNA shedding duration, described participant characteristics associated with the first negative rRT-PCR test (resolution), and determined if replication-competent viruses was recoverable ≥10 days after symptom onset.MethodsWe collected serial nasopharyngeal specimens from 109 individuals with rRT-PCR-confirmed COVID-19 in Utah and Wisconsin. We calculated viral RNA shedding resolution probability using the Kaplan-Meier estimator and evaluated characteristics associated with shedding resolution using Cox proportional hazards regression. We attempted viral culture for 35 rRT-PCR-positive nasopharyngeal specimens collected ≥10 days after symptom onset.ResultsThe likelihood of viral RNA shedding resolution at 10 days after symptom onset was approximately 3%. Time to shedding resolution was shorter among participants aged <18 years (adjusted hazards ratio [aHR], 3.01; 95% confidence interval [CI], 1.6-5.6) and longer among those aged ≥50 years (aHR, 0.50; 95% CI, .3-.9) compared to participants aged 18-49 years. No replication-competent viruses were recovered.ConclusionsAlthough most patients were positive for SARS-CoV-2 for ≥10 days after symptom onset, our findings suggest that individuals with mild to moderate COVID-19 are unlikely to be infectious ≥10 days after symptom onset.Published by Oxford University Press for the Infectious Diseases Society of America 2021.

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