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Knowing the period of transmission of the virus is an important element to prevent the transmission of the coronavirus. Doctors from the Therapeutic Clinic of the Faculty of Medicine of the National and Kapodistria University of Athens, Theodora Psaltopoulou, Ioannis Danasis, Maria Gavriatopoulou and Thanos Dimopoulos (Rector of EKPA) summarize the results of a review study recently published in the Journal.
The authors searched the entire literature from January 1 to August 26, 2020 to identify studies regarding the transmission period of patients with confirmed COVID-19 infection, that is, with a positive PCR test for the SARS virus. CoV-2. In total, 15 relevant studies were found and accumulated, including 13 studies with SARS-CoV-2 virus culture data and 2 studies with trace data.
In 5 studies, the new SARS-CoV-2 coronavirus could be detected up to the 10th day after the onset of symptoms. In 5 other studies, detection of SARS-CoV-2 was possible beyond the 10th day after the onset of symptoms in only 3% of patients. The other 3 studies included patients with severe COVID-19 illness. In these cases, the SARS-CoV-2 virus was isolated up to 32 days after the onset of symptoms. In two studies involving immunosuppressed patients, SARS-CoV-2 was isolated up to 20 days after onset of symptoms.
With regard to follow-up studies, when there was close contact of infected individuals with a confirmed case more than 5 days after the onset of the patients’ symptoms, there was no direct, laboratory-confirmed transmission of SARS-CoV-2 from person to person.
In conclusion, patients with mild to moderate COVID-19 infection are likely not contagious after the 10th day after the onset of symptoms. However, there is evidence that patients with severe disease, as well as those who are immunosuppressed, can transmit SARS-CoV-2 for a longer period of time.
These results are in accordance with the guidelines of the US Centers for Disease Control (CDC), which recommend the following:
For most people with COVID-19 infection, isolation and precautions can generally be stopped 10 days after the onset of symptoms and the absence of fever for at least 24 hours without the use of antipyretics, while others symptoms improve. Immunosuppressed patients and those with serious illnesses should be evaluated by treating physicians.
For people who will never develop symptoms, isolation and other precautions can be suspended 10 days after the date of the first positive RT-PCR test for SARS-CoV-2 RNA (COVID-19 test).
The evaluation of the PCR test for isolation interruption and precautions is not recommended if the conditions previously analyzed according to clinical criteria are met.
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