Persistent detection of SARS-CoV-2 RNA in patients and healthcare workers with COVID-19
- Resource Type
- Authors
- Marcello Chang; Benjamin A. Pinsky; Nigam H. Shah; Saurabh Gombar; Catherine A. Hogan; James L. Zehnder; Scott D. Boyd
- Source
- Journal of Clinical Virology
- Subject
- Adult
Male
0301 basic medicine
medicine.medical_specialty
Time Factors
Coronavirus disease 2019 (COVID-19)
Health Personnel
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Pneumonia, Viral
030106 microbiology
RT-PCR
Article
Betacoronavirus
03 medical and health sciences
0302 clinical medicine
Virology
Pandemic
Health care
SARS−COV-2
medicine
Humans
Healthcare workers
In patient
030212 general & internal medicine
Viral shedding
Pandemics
Aged
Aged, 80 and over
Reverse Transcriptase Polymerase Chain Reaction
SARS-CoV-2
business.industry
COVID-19
Middle Aged
Virus Shedding
Transmission-based precautions
Infectious Diseases
Emergency medicine
Workforce
RNA, Viral
Female
Coronavirus Infections
business
- Language
- ISSN
- 1386-6532
Background Current guidelines for returning health care workers (HCW) to service after a positive SARS-CoV-2 RT-PCR test and ceasing of transmission precautions for patients is based on two general strategies. A test-based strategy that requires negative respiratory RT-PCR tests obtained after the resolution of symptoms. Alternatively, due to the limited availability of testing, many sites employ a symptom-based strategy that recommends excluding HCW from the workforce and keeping patients on contact precautions until a fixed period of time has elapsed from symptom recovery. The underlying assumption of the symptom-based strategy is that waiting for a fixed period of time is a surrogate for negative RT-PCR testing, which itself is a surrogate for the absence of shedding infectious virus. Objectives To better understand the appropriate length of symptom based return to work and contact precaution strategies. Study Design We performed an observational analysis of 150 patients and HCW that transitioned from RT-PCR SARS-CoV-2 positive to negative over the course of 2 months at a US academic medical center. Results We found that the average time to transition from RT-PCR positive to negative was 24 days after symptom onset and 10 % remained positive even 33 days after symptom onset. No difference was seen in HCW and patients. Conclusions These findings suggest until definitive evidence of the length of infective viral shedding is obtained that the fixed length of time before returning to work or ceasing contract precautions be revised to over one-month.