Objective: Transmission of SARS-CoV-2 has significant implications for hospital infection prevention and control, discharge management, and public health. We reviewed available literature to reach an evidenced-based consensus on the expected duration of viral shedding. Design: We queried 4 scholarly repositories and search engines for studies reporting SARS-CoV-2 viral shedding dynamics by PCR and/or culture available through September 8, 2020. We calculated the pooled median duration of viral RNA shedding from respiratory and fecal sources. Results: The review included 77 studies on SARS-CoV-2. All studies reported PCR-based testing and 12 also included viral culture data. Among 28 studies, the overall pooled median duration of RNA shedding from respiratory sources was 18.4 days (95% CI, 15.5–21.3; I 2 = 98.87%; P < .01). When stratified by disease severity, the pooled median duration of viral RNA shedding from respiratory sources was 19.8 days (95% CI, 16.2–23.5; I 2 = 96.42%; P < .01) among severely ill patients and 17.2 days (95% CI, 14.0–20.5; I 2 = 95.64%; P < .01) in mild-to-moderate illness. Viral RNA was detected up to 92 days after symptom onset. Viable virus was isolated by culture from −6 to 20 days relative to symptom onset. Conclusions: SARS-COV-2 RNA shedding can be prolonged, yet high heterogeneity exists. Detection of viral RNA may not correlate with infectivity since available viral culture data suggests shorter durations of shedding of viable virus. Additional data are needed to determine the duration of shedding of viable virus and the implications for risk of transmission.
【초록키워드】 public health, SARS-CoV-2, disease severity, hospital, viral shedding, detection, virus, heterogeneity, discharge, RNA, Viral, PCR, Culture, management, Infection prevention, shedding, SARS-CoV-2 RNA, Viral RNA, respiratory, viral culture, Prevention and control, fecal, Mild-to-moderate, symptom onset, Consensus, Viral RNA shedding, Repository, 95% CI, PCR-based testing, SARS-CoV-2 viral shedding, severely ill patients, implication, risk of transmission, reported, median, calculated, determine, expected, stratified, severely ill patient, Viable, 【제목키워드】 review, virus, Viral, understanding, respiratory, Respiratory Coronavirus,