Infectivity of Adult and Pediatric COVID-19 Patients

Abstract

Objective: We aimed to describe the infectivity of adult and pediatric COVID-19 patients in the presence of viral shedding and anti-SARS-CoV-2 antibody response. Materials and Methods:A total of 408 consequent samples from eleven adults and five pediatric patients with SARS-CoV-2 infection were included. Reverse transcription-polymerase chain reaction (RT-PCR) and viral culture were performed for the samples obtained every other day from saliva, nasopharynx, feces, serum, urine, and tear. Anti-SARS-CoV-2 antibodies were measured. Results:The median duration of RNA shedding in all specimens was 7 (2-15) days in adults and 5 (3-19) days in children. The median duration from symptom onset to admission was three days. The viral RNA was positive in 44.7 % of the nasopharynx and 37.6% of saliva samples up to 16 days in adults and 19 days in children. We detected the latest viral culture positivity in the nasopharynx on day eight of symptoms. The viral RNA was found in 6.1% of feces, 4.4% of serum, 4.3 % of tear, 2.9% of urine. The earliest seroconversion was the seventh day for adults and the eighth day for children. On the 14th day, total antibody positivity was 78% in adults and 80% in children. After seroconversion, the viral RNA was still detected in the nasopharynx and saliva of three patients; however, the infectious virus was not present. Conclusion:The infectivity of a positive patient is low after eight days of symptoms. The risk of fecal-oral transmission is very low, and strict hand hygiene measures could be preventive.

Viral shedding of SARS-CoV-2 in body fluids associated with sexual activity: a systematic review and meta-analysis

“…However, a recent meta-analysis showed that infectious potential declined after 9 days, even among patients with high viral loads in a respiratory specimen inferred from cycle threshold values. 68 69 In the present systematic review, virus isolation in saliva was attempted by nine studies, 15–23 but the presence of a typical cytopathic effect and detectable viral particles in the supernatant was reported by only four studies. 17–19 22 …”

“…Virus isolation was attempted by nine studies15–23 and viral cultures were successfully performed in six,17–19 21–23 although the presence of typical cytopathic effect and or increased viral in the supernatant was reported in only four of them,17–19 22 with one of the studies showing that most patients shed live virus for ≥20 days 19…”

“…Three studies attempted viral isolation in Vero cells 15 52 53. Two urine sediment specimens generated cytopathic growth in the study by Caceres et al ; however, subsequent RT-PCR failed to amplify any SARS-CoV-2 genetic material isolated from the culture cells 53.…”

“…Viral isolation was attempted by seven studies,15 16 52 64–67 but only one achieved its goal by isolating viral particles from Vero E6 epithelial cell monolayers inoculated with stool specimens of 6.25% (7/112) patients without specifying the time elapsed between the symptoms onset and isolation 67…”