Prolonged presence of replication-competent SARS-CoV-2 in mildly symptomatic individuals: A Report of 2 Cases

Abstract

It has been estimated that individuals with COVID-19 can shed replication-competent virus up to a maximum of twenty days after initiation of symptoms. This report describes two patients with mild forms of the disease who shed replication-competent virus for 24 and 37 days, respectively, after symptom onset.

SARS-CoV-2 PCR Persistence and Duration of COVID-19 Symptoms in Health Professionals

“…Most studies with patients who were followed-up after SARS-CoV-2 infection and showed persistence of viral detection by RT-qPCR did not succeed in isolating replicationcompetent virus; 11 notwithstanding, a recent study with two cases of persistent viral infection successfully obtained replicative virus from patients' samples 24 and 37 days after symptom onset. 7 The capacity of infected individuals to transmit SARS-CoV-2 is higher on the first days or even before symptoms onset, however asymptomatic people can also be contagious. 11 On the other hand, carrying replication-competent virus is not sufficient for an individual to be infective, as most studies did not find an association between SARS-CoV-2 PCR persistence and transmissibility.…”

“…6 Though persistence of SARS-CoV-2 PCR positivity does not necessarily indicate that an individual still carries replication-competent virus, a recent study was successful in recovering viable viral particles from two patients with mild COVID-19, 24 and 37 days after symptom onset. 7 These findings raise again concerns about long-term virus persistence and the possibility of an individual transmitting the virus even after full recovery. More studies showing persistence of viral RNA in asymptomatic, mild and moderate COVID-19 cases will help understanding the course of SARS-CoV-2 infection.…”