Temporal profile and determinants of viral shedding and of viral clearance confirmation on nasopharyngeal swabs from SARS-CoV-2-positive subjects: a population-based prospective cohort study in Reggio Emilia, Italy

ObjectivesTo determine the timing of viral clearance (first negative RT-PCR on nasopharyngeal swab) and the probability of viral clearance confirmation (two consecutive negative swabs) in COVID-19 patients and to identify related determinants.DesignPopulation-based prospective cohort study on archiv...

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Published inBMJ open Vol. 10; no. 8; p. e040380
Main Authors Mancuso, Pamela, Venturelli, Francesco, Vicentini, Massimo, Perilli, Cinzia, Larosa, Elisabetta, Bisaccia, Eufemia, Bedeschi, Emanuela, Zerbini, Alessandro, Giorgi Rossi, Paolo, Costantini, Massimo, Grilli, Roberto, Marino, Massimiliano, Formoso, Giulio, Formisano, Debora, Venturi, Ivano, Campari, Cinzia, Gioia, Francesco, Broccoli, Serena, Ottone, Marta, Pattacini, Pierpaolo, Besutti, Giulia, Iotti, Valentina, Spaggiari, Lucia, Seidenari, Chiara, Veronesi, Licia, Affanni, Paola, Colucci, Maria Eugenia, Nitrosi, Andrea, Foracchia, Marco, Colla, Rossana, Massari, Marco, Ferrari, Anna Maria, Pinotti, Mirco, Facciolongo, Nicola, Lattuada, Ivana, Trabucco, Laura, Pietri, Stefano De, Danelli, Giorgio Francesco, Albertazzi, Laura, Bellesia, Enrica, Canovi, Simone, Corradini, Mattia, Fasano, Tommaso, Magnani, Elena, Pilia, Annalisa, Polese, Alessandra, Incerti, Silvia Storchi, Zaldini, Piera, Bonelli, Efrem, Orsola, Bonanno, Revelli, Matteo, Salvarani, Carlo, Pinto, Carmine
Format Journal Article
LanguageEnglish
Published England British Medical Journal Publishing Group 02.09.2020
BMJ Publishing Group LTD
BMJ Publishing Group
SeriesOriginal research
Subjects
Adult
Age Factors
Aged
Betacoronavirus
Cohort analysis
Coronavirus Infections - complications
Coronavirus Infections - diagnosis
Coronavirus Infections - virology
COVID-19
Data analysis
Diagnostic tests
epidemiology
Female
Hospitalization
Humans
infectious diseases
Italy
Logistic Models
Male
Medical laboratories
Middle Aged
Nasopharynx - virology
Pandemics
Pneumonia, Viral - complications
Pneumonia, Viral - diagnosis
Pneumonia, Viral - virology
Population-based studies
Prospective Studies
Public Health
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Severity of Illness Index
Specimen Handling
Time Factors
Virus Shedding
Italy
Reggio Emilia Italy
Online AccessGet full text
ISSN2044-6055
2044-6055
DOI10.1136/bmjopen-2020-040380

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Abstract ObjectivesTo determine the timing of viral clearance (first negative RT-PCR on nasopharyngeal swab) and the probability of viral clearance confirmation (two consecutive negative swabs) in COVID-19 patients and to identify related determinants.DesignPopulation-based prospective cohort study on archive data.SettingPreventive services and hospital care in the Reggio Emilia province, northern Italy.ParticipantsAll 1162 subjects testing positive to RT-PCR on nasopharyngeal swabs and diagnosed with COVID-19 in the Reggio Emilia province with at least 30 days of follow-up by 22 April 2020.Main outcome measuresMedian times from diagnosis and from symptom onset to viral clearance with IQR assessed using the Kaplan–Meier estimator, stratified by included characteristics. The probability of viral clearance confirmation, stratified by time from diagnosis and putative determinants assessed using a multivariate logistic regression model.ResultsViral clearance was achieved by 60.6% (704/1162) of patients, with a median time of 30 days from diagnosis (IQR 23–40) and 36 days from symptom onset (IQR 28–45). Of those negative and retested, 78.7% (436/554) had viral clearance confirmation, suggesting one in five false negative tests. The time from symptom onset to viral clearance slightly increased with age, from 35 (IQR 26–44) days under age 50 to 38 (IQR 28–44) in over age 80, and with disease severity, from 33 (IQR 25–41) days in non-hospitalised subjects to 38 (IQR 30–47) days in hospitalised patients. The probability of confirmed viral clearance reached 86.8% after 34 days from symptom onset and increased with time, even when adjusting for age and sex (OR 1.16 95% CI 1.06 to 1.26 per day from diagnosis).ConclusionsPostponing follow-up testing of clinically recovered COVID-19 patients could increase the efficiency and performance of testing protocols. Understanding viral shedding duration also has implications for containment measures of paucisymptomatic subjects.
AbstractList Objectives To determine the timing of viral clearance (first negative RT-PCR on nasopharyngeal swab) and the probability of viral clearance confirmation (two consecutive negative swabs) in COVID-19 patients and to identify related determinants.Design Population-based prospective cohort study on archive data.Setting Preventive services and hospital care in the Reggio Emilia province, northern Italy.Participants All 1162 subjects testing positive to RT-PCR on nasopharyngeal swabs and diagnosed with COVID-19 in the Reggio Emilia province with at least 30 days of follow-up by 22 April 2020.Main outcome measures Median times from diagnosis and from symptom onset to viral clearance with IQR assessed using the Kaplan–Meier estimator, stratified by included characteristics. The probability of viral clearance confirmation, stratified by time from diagnosis and putative determinants assessed using a multivariate logistic regression model.Results Viral clearance was achieved by 60.6% (704/1162) of patients, with a median time of 30 days from diagnosis (IQR 23–40) and 36 days from symptom onset (IQR 28–45). Of those negative and retested, 78.7% (436/554) had viral clearance confirmation, suggesting one in five false negative tests. The time from symptom onset to viral clearance slightly increased with age, from 35 (IQR 26–44) days under age 50 to 38 (IQR 28–44) in over age 80, and with disease severity, from 33 (IQR 25–41) days in non-hospitalised subjects to 38 (IQR 30–47) days in hospitalised patients. The probability of confirmed viral clearance reached 86.8% after 34 days from symptom onset and increased with time, even when adjusting for age and sex (OR 1.16 95% CI 1.06 to 1.26 per day from diagnosis).Conclusions Postponing follow-up testing of clinically recovered COVID-19 patients could increase the efficiency and performance of testing protocols. Understanding viral shedding duration also has implications for containment measures of paucisymptomatic subjects.
ObjectivesTo determine the timing of viral clearance (first negative RT-PCR on nasopharyngeal swab) and the probability of viral clearance confirmation (two consecutive negative swabs) in COVID-19 patients and to identify related determinants.DesignPopulation-based prospective cohort study on archive data.SettingPreventive services and hospital care in the Reggio Emilia province, northern Italy.ParticipantsAll 1162 subjects testing positive to RT-PCR on nasopharyngeal swabs and diagnosed with COVID-19 in the Reggio Emilia province with at least 30 days of follow-up by 22 April 2020.Main outcome measuresMedian times from diagnosis and from symptom onset to viral clearance with IQR assessed using the Kaplan–Meier estimator, stratified by included characteristics. The probability of viral clearance confirmation, stratified by time from diagnosis and putative determinants assessed using a multivariate logistic regression model.ResultsViral clearance was achieved by 60.6% (704/1162) of patients, with a median time of 30 days from diagnosis (IQR 23–40) and 36 days from symptom onset (IQR 28–45). Of those negative and retested, 78.7% (436/554) had viral clearance confirmation, suggesting one in five false negative tests. The time from symptom onset to viral clearance slightly increased with age, from 35 (IQR 26–44) days under age 50 to 38 (IQR 28–44) in over age 80, and with disease severity, from 33 (IQR 25–41) days in non-hospitalised subjects to 38 (IQR 30–47) days in hospitalised patients. The probability of confirmed viral clearance reached 86.8% after 34 days from symptom onset and increased with time, even when adjusting for age and sex (OR 1.16 95% CI 1.06 to 1.26 per day from diagnosis).ConclusionsPostponing follow-up testing of clinically recovered COVID-19 patients could increase the efficiency and performance of testing protocols. Understanding viral shedding duration also has implications for containment measures of paucisymptomatic subjects.
Author Grilli, Roberto
Formoso, Giulio
Bedeschi, Emanuela
Revelli, Matteo
Foracchia, Marco
Zaldini, Piera
Seidenari, Chiara
Lattuada, Ivana
Pattacini, Pierpaolo
Besutti, Giulia
Ferrari, Anna Maria
Pilia, Annalisa
Orsola, Bonanno
Polese, Alessandra
Facciolongo, Nicola
Vicentini, Massimo
Iotti, Valentina
Trabucco, Laura
Bellesia, Enrica
Nitrosi, Andrea
Perilli, Cinzia
Marino, Massimiliano
Veronesi, Licia
Colucci, Maria Eugenia
Albertazzi, Laura
Costantini, Massimo
Pietri, Stefano De
Danelli, Giorgio Francesco
Bisaccia, Eufemia
Colla, Rossana
Campari, Cinzia
Canovi, Simone
Giorgi Rossi, Paolo
Corradini, Mattia
Broccoli, Serena
Venturelli, Francesco
Bonelli, Efrem
Zerbini, Alessandro
Gioia, Francesco
Incerti, Silvia Storchi
Massari, Marco
Mancuso, Pamela
Venturi, Ivano
Ottone, Marta
Formisano, Debora
Magnani, Elena
Fasano, Tommaso
Spaggiari, Lucia
Pinto, Carmine
Pinotti, Mirco
Larosa, Elisabetta
Salvarani, Carlo
Affanni, Paola
AuthorAffiliation 4 Clinical Immunology, Allergy and Advanced Biotechnologies Unit , Azienda USL-IRCCS di Reggio Emilia , Reggio Emilia , Italy
2 PhD Course Clinical and Experimental Medicine , University of Modena and Reggio Emilia , Modena , Italy
1 Epidemiology Unit , Azienda USL-IRCCS di Reggio Emilia , Reggio Emilia , Emilia-Romagna , Italy
3 Public Health Service , Azienda USL-IRCCS di Reggio Emilia , Reggio Emilia , Italy
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/32878768$$D View this record in MEDLINE/PubMed
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Cites_doi 10.1056/NEJMc2001737
10.1016/S1473-3099(20)30120-1
10.1016/S0140-6736(20)30690-5
10.1016/j.healun.2020.03.012
10.1056/NEJMoa2002032
10.1016/S2213-2600(20)30116-8
10.1148/radiol.2020201343
10.1038/s41586-020-2196-x
10.1016/S0140-6736(20)30566-3
10.1016/S0140-6736(20)30868-0
10.1183/13993003.00799-2020
10.1038/s41586-020-2488-1
10.1038/s41591-020-0869-5
10.1136/bmj.m1443
10.1128/mBio.00722-20
10.7326/M20-1301
10.1016/S1473-3099(20)30196-1
10.1371/journal.pone.0238281
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Copyright Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
2020 Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2020
Copyright_xml – notice: Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
– notice: 2020 Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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References Patel, Babady, Theel (R20) 2020; 11
Guan, Ni, Hu (R10) 2020; 382
He, Lau, Wu (R30) 2020; 26
Siddiqi, Mehra (R9) 2020; 39
Wikramaratna, Paton, Ghafari (R19) 2020; 2020.04.05.20053355
Zhou, Yu, Du (R27) 2020; 395
Riccardo, Ajelli, Andrianou (R6) 2020; 2020.04.08.20056861
Giorgi Rossi, Marino, Formisano (R8) 2020; 15
Kim, Hong, Yoon (R26) 2020; 296
Wölfel, Corman, Guggemos (R33) 2020; 581
Tan, Kang, Zhang (R29) 2020; 2020.03.22.20040071
Zou, Ruan, Huang (R32) 2020; 382
Saglietto, D'Ascenzo, Zoccai (R3) 2020; 395
Lavezzo, Franchin, Ciavarella (R38) 2020; 584
Yan, Liu, Zhu (R28) 2020; 56
To, Tsang, Leung (R31) 2020; 20
Zheng, Fan, Yu (R34) 2020; 369
Fang, Karakiulakis, Roth (R11) 2020; 8
Dong, Du, Gardner (R2) 2020; 20
Giorgi Rossi (R5) 2020; 128
Cheng, Papenburg, Desjardins (R21) 2020; 172
Atkinson, Petersen (R18) 2020; 395
References_xml – volume: 382
  start-page: 1177
  year: 2020
  ident: R32
  article-title: SARS-CoV-2 viral load in upper respiratory specimens of infected patients
  publication-title: N Engl J Med
  doi: 10.1056/NEJMc2001737
– volume: 20
  start-page: 533
  year: 2020
  ident: R2
  article-title: An interactive web-based dashboard to track COVID-19 in real time
  publication-title: Lancet Infect Dis
  doi: 10.1016/S1473-3099(20)30120-1
– volume: 395
  start-page: 1110
  year: 2020
  ident: R3
  article-title: COVID-19 in Europe: the Italian lesson
  publication-title: Lancet
  doi: 10.1016/S0140-6736(20)30690-5
– volume: 39
  start-page: 405
  year: 2020
  ident: R9
  article-title: COVID-19 illness in native and immunosuppressed states: a clinical-therapeutic staging proposal
  publication-title: J Heart Lung Transplant
  doi: 10.1016/j.healun.2020.03.012
– volume: 2020.04.05.20053355
  year: 2020
  ident: R19
  article-title: Estimating false-negative detection rate of SARS-CoV-2 by RT-PCR
  publication-title: medRxiv
– volume: 382
  start-page: 1708
  year: 2020
  ident: R10
  article-title: Clinical characteristics of coronavirus disease 2019 in China
  publication-title: N Engl J Med
  doi: 10.1056/NEJMoa2002032
– volume: 8
  year: 2020
  ident: R11
  article-title: Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?
  publication-title: Lancet Respir Med
  doi: 10.1016/S2213-2600(20)30116-8
– volume: 296
  start-page: E145
  year: 2020
  ident: R26
  article-title: Diagnostic performance of CT and reverse transcriptase polymerase chain reaction for coronavirus disease 2019: a meta-analysis
  publication-title: Radiology
  doi: 10.1148/radiol.2020201343
– volume: 581
  start-page: 465
  year: 2020
  ident: R33
  article-title: Virological assessment of hospitalized patients with COVID-2019
  publication-title: Nature
  doi: 10.1038/s41586-020-2196-x
– volume: 395
  start-page: 1054
  year: 2020
  ident: R27
  article-title: Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
  publication-title: Lancet
  doi: 10.1016/S0140-6736(20)30566-3
– volume: 395
  start-page: 1339
  year: 2020
  ident: R18
  article-title: SARS-CoV-2 shedding and infectivity
  publication-title: Lancet
  doi: 10.1016/S0140-6736(20)30868-0
– volume: 2020.03.22.20040071
  year: 2020
  ident: R29
  article-title: A special case of COVID-19 with long duration of viral shedding for 49 days
  publication-title: medRxiv
– volume: 128
  start-page: 104415
  year: 2020
  ident: R5
  article-title: Emilia-Romagna COVID-19 Working group case fatality rate in patients with COVID-19 infection and its relationship with length of follow up
  publication-title: J Clin Virol
– volume: 56
  year: 2020
  ident: R28
  article-title: Factors associated with prolonged viral shedding and impact of lopinavir/ritonavir treatment in hospitalised non-critically ill patients with SARS-CoV-2 infection
  publication-title: Eur Respir J
  doi: 10.1183/13993003.00799-2020
– volume: 584
  start-page: 425
  year: 2020
  ident: R38
  article-title: Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo’
  publication-title: Nature
  doi: 10.1038/s41586-020-2488-1
– volume: 26
  start-page: 672
  year: 2020
  ident: R30
  article-title: Temporal dynamics in viral shedding and transmissibility of COVID-19
  publication-title: Nat Med
  doi: 10.1038/s41591-020-0869-5
– volume: 369
  year: 2020
  ident: R34
  article-title: Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang Province, China, January–March 2020: retrospective cohort study
  publication-title: BMJ
  doi: 10.1136/bmj.m1443
– volume: 2020.04.08.20056861
  year: 2020
  ident: R6
  article-title: Epidemiological characteristics of COVID-19 cases in Italy and estimates of the reproductive numbers one month into the epidemic
  publication-title: medRxiv
– volume: 11
  year: 2020
  ident: R20
  article-title: Report from the American Society for microbiology COVID-19 international Summit, 23 March 2020: value of diagnostic testing for SARS-CoV-2/COVID-19
  publication-title: mBio
  doi: 10.1128/mBio.00722-20
– volume: 172
  start-page: 726
  year: 2020
  ident: R21
  article-title: Diagnostic testing for severe acute respiratory syndrome-related coronavirus 2
  publication-title: Ann Intern Med
  doi: 10.7326/M20-1301
– volume: 20
  start-page: 565
  year: 2020
  ident: R31
  article-title: Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study
  publication-title: Lancet Infect Dis
  doi: 10.1016/S1473-3099(20)30196-1
– volume: 15
  year: 2020
  ident: R8
  article-title: Characteristics and outcomes of a cohort of COVID-19 patients in the province of Reggio Emilia, Italy
  publication-title: PLoS One
  doi: 10.1371/journal.pone.0238281
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Snippet ObjectivesTo determine the timing of viral clearance (first negative RT-PCR on nasopharyngeal swab) and the probability of viral clearance confirmation (two...
Objectives To determine the timing of viral clearance (first negative RT-PCR on nasopharyngeal swab) and the probability of viral clearance confirmation (two...
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SubjectTerms Adult
Age Factors
Aged
Betacoronavirus
Cohort analysis
Coronavirus Infections - complications
Coronavirus Infections - diagnosis
Coronavirus Infections - virology
COVID-19
Data analysis
Diagnostic tests
epidemiology
Female
Hospitalization
Humans
infectious diseases
Italy
Logistic Models
Male
Medical laboratories
Middle Aged
Nasopharynx - virology
Pandemics
Pneumonia, Viral - complications
Pneumonia, Viral - diagnosis
Pneumonia, Viral - virology
Population-based studies
Prospective Studies
Public Health
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Severity of Illness Index
Specimen Handling
Time Factors
Virus Shedding
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Title Temporal profile and determinants of viral shedding and of viral clearance confirmation on nasopharyngeal swabs from SARS-CoV-2-positive subjects: a population-based prospective cohort study in Reggio Emilia, Italy
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