Health Information and Quality Authority, Smithfield, Dublin 7, Ireland.
Health Information and Quality Authority, Smithfield, Dublin 7, Ireland.
J Infect. 2020 Dec;81(6):847-856. doi: 10.1016/j.jinf.2020.10.009. Epub 2020 Oct 10.
To summarise the evidence on the duration of infectiousness of individuals in whom SARS-CoV-2 ribonucleic acid is detected.
A rapid review was undertaken in PubMed, Europe PubMed Central and EMBASE from 1 January 2020 to 26 August 2020.
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.
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.
总结已检测到 SARS-CoV-2 核糖核酸个体的传染性持续时间的证据。
在 2020 年 1 月 1 日至 2020 年 8 月 26 日期间,在 PubMed、欧洲 PubMed 中心和 EMBASE 中进行了快速审查。
我们确定了 15 项相关研究,包括 13 项病毒培养和 2 项接触者追踪研究。对于 5 项病毒培养研究,SARS-CoV-2 分离的最后一天发生在症状出现后 10 天内。对于另外 5 项研究,大约 3%的纳入患者的 SARS-CoV-2 分离超过 10 天。其余 3 项病毒培养研究包括患有严重或危重病的患者;在一项研究中,SARS-CoV-2 被分离至第 32 天。有 2 项研究从免疫功能低下的患者中分离出 SARS-CoV-2,最长分离时间为 20 天。当接触者在病例出现后超过 5 天首次暴露时,这两项接触者追踪研究均未发现 SARS-CoV-2 实验室确诊的传播证据。
症状出现后 10 天以上,轻度至中度疾病的 COVID-19 患者极不可能具有传染性。然而,少数研究的证据表明,严重至危重病患者或免疫功能低下的患者可能会更长时间排出具有传染性的病毒。