Determining the period of communicability of SARS-CoV-2: A rapid review of the literature

Publication date: Jul 29, 2020

Introduction: How long individuals may transmit virus after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear. Understanding the communicability period of SARS-CoV-2 is important to inform the period of isolation required to prevent nosocomial and community spread. The objective of this study was to identify the reported communicable period of SARS-CoV-2, based on a rapid review of existing literature. Methods: Studies reporting empirical data on the period of communicability of SARS-CoV-2 through investigations of duration of communicability based on in-person contact (‘contact transmission’), isolation and culture of virus (‘viral isolation’), and viral shedding by detection of nucleic acids by RT-PCR (‘viral shedding’) were identified through searches of peer-reviewed and pre-print health sciences literature databases (Ovid MEDLINE, Embase, Google Scholar, medRxiv and arXiv) and the grey literature. Articles were screened for relevance, then data were extracted, analyzed, and synthesized. Results: Out of the 165 studies included for qualitative analysis, one study investigated contact transmission, three investigated viral isolation, 144 investigated viral shedding, and 17 studies focused on both viral shedding and viral isolation. The median length of time until viral clearance across all viral isolation studies was nine days; however, the maximum identified duration was 32 days. Studies with data on both viral isolation and viral shedding showed a prolonged maximum time until viral clearance for viral shedding (9 days vs 24 days). Discussion: Findings from this review support a minimum 10-day period of isolation; however, additional observation should be considered for individuals being released into high-risk settings.

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Concepts Keywords
3 Hong Kong Infectious diseases
Acute Care Epidemiology
ArXiv Zoonoses
Asia Medicine
Asymptomatic Medical specialties
Australia Health
British Columbia Heart transplant
Bronchial Lavage Kidney transplant
Canada Infectious Diseases
China Virus infection
Clinical Trial Infectious virus
Coronavirus Mild severe disease
Cross Pre register protocol
Embase Pneumonia Internet Transplant
Europe Internet Stockholm ECDC
Finland Search systematic review
Flowchart Infection Internet
France Quality processing
Frequency Clinical management
Germany Test discharge Internet
Google Scholar Sensitivity search
Grey Literature Internet Control Prevention
Healthcare Short communications
Hospital Internet STAT
India Sarbecovirus
Infection Bat virome
Intensive Care Unit Coronavirus disease
IQR Antibodies
Italy Transplantation
Japan Html
John Harding Http
Lebanon
Medians
MEDLINE
Middle East
Mina
Nasal
Netherlands
North America
Nosocomial
Nucleic Acid
Nucleic Acids
Ovid
Park
PCR
Pediatric
Pharyngeal
Polymerase Chain Reaction
Protocol
Qualitative Analysis
Quarantine
Raw
Register
Respiratory Tract
Reverse Transcriptase
RT
Saliva
SARS
Saudi Arabia
Scotland
Singapore
South Korea
Spain
Sputum
Statistical Modelling
Symptom
Taiwan
Thailand
United Arab Emirates
Vancouver
Vietnam
Viral
Viral Shedding
Virus

Semantics

Type Source Name
disease MESH community
disease IDO communicability period
disease MESH infection
disease IDO communicability
disease MESH viral shedding
disease VO Canada
disease MESH virus infection
disease MESH death
disease MESH viral load
disease MESH complications
drug DRUGBANK Coenzyme M
disease MESH development
drug DRUGBANK Hydroxychloroquine
drug DRUGBANK Azithromycin
disease VO Pla
disease IDO replication
disease MESH Risk Factors
disease MESH Recurrence
drug DRUGBANK (S)-Des-Me-Ampa
disease MESH pneumonia
disease MESH Infectious Diseases
disease IDO infectivity
disease MESH Allergy
disease VO country

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