scholarly journals Prolonged Viral Shedding in Vertically Acquired SARS-CoV-2 Infection in Preterm Infants–Shedding Versus Infectivity

2021 ◽  
pp. 097321792110656
Author(s):  
Chokkiyil Ponnambath Hafis Ibrahim ◽  
Amir Mohammed Abelshafy ◽  
Maqbool Qadir
Keyword(s):  
Infection Control ◽  
Preterm Infants ◽  
Acute Phase ◽  
Median Duration ◽  
Ribonucleic Acid ◽  
Viral Rna ◽  
Newborn Period ◽  
Live Virus ◽  
Viral Shedding

The reported median duration of viral shedding after infection with SARS-CoV2 is between 12 and 20 days. It is now established that infected individuals can continue to shed viral ribonucleic acid (RNA) without shedding live virus. This has implications for quarantine and infection control practices. COVID in the acute phase seems to be milder in children, and the duration of viral RNA shedding is shorter in children compared to adults. SARS-CoV-2 infections in the newborn period is rare. Little is known about the duration of viral shedding in preterm infants with vertically acquired SARS-CoV-2. 3 of the 4 preterm infants cared for at our center had prolonged shedding up to 34 days with live viral shedding not seen beyond the second week when tested in 3 of them.

scholarly journals SARS-CoV-2, SARS-CoV-1 and MERS-CoV viral load dynamics, duration of viral shedding and infectiousness: a living systematic review and meta-analysis

2020 ◽  
Author(s):  
Muge Cevik ◽  
Matthew Tate ◽  
Oliver Lloyd ◽  
Alberto Enrico Maraolo ◽  
Jenna Schafers ◽  
...  
Keyword(s):  
Viral Load ◽  
Respiratory Tract ◽  
Symptom Onset ◽  
Grey Literature ◽  
Viral Rna ◽  
Viral Dynamics ◽  
Upper Respiratory Tract ◽  
Live Virus ◽  
Viral Shedding ◽  
Upper Respiratory

Background Viral load kinetics and the duration of viral shedding are important determinants for disease transmission. We aim i) to characterise viral load dynamics, duration of viral RNA, and viable virus shedding of SARS-CoV-2 in various body fluids and ii) to compare SARS-CoV-2 viral dynamics with SARS-CoV-1 and MERS-CoV. Methods: Medline, EMBASE, Europe PMC, preprint servers and grey literature were searched to retrieve all articles reporting viral dynamics and duration of SARS-CoV-2, SARS-CoV-1 and MERS-CoV shedding. We excluded case reports and case series with < 5 patients, or studies that did not report shedding duration from symptom onset. PROSPERO registration: CRD42020181914. Findings: Seventy-nine studies on SARS-CoV-2, 8 on SARS-CoV-1, and 11 on MERS-CoV were included. Mean SARS-CoV-2 RNA shedding duration in upper respiratory tract, lower respiratory tract, stool and serum were 17.0, 14.6, 17.2 and 16.6 days, respectively. Maximum duration of SARS-CoV-2 RNA shedding reported in URT, LRT, stool and serum was 83, 59, 35 and 60 days, respectively. Pooled mean duration of SARS-CoV-2 RNA shedding was positively associated with age (p=0.002), but not gender (p = 0.277). No study to date has detected live virus beyond day nine of illness despite persistently high viral loads. SARS-CoV-2 viral load in the upper respiratory tract appears to peak in the first week of illness, while SARS-CoV-1 and MERS-CoV peak later. Conclusion: Although SARS-CoV-2 RNA shedding in respiratory and stool can be prolonged, duration of viable virus is relatively short-lived. Thus, detection of viral RNA cannot be used to infer infectiousness. High SARS-CoV-2 titres are detectable in the first week of illness with an early peak observed at symptom onset to day 5 of illness. This review underscores the importance of early case finding and isolation, as well as public education on the spectrum of illness. However, given potential delays in the isolation of patients, effective containment of SARS-CoV-2 may be challenging even with an early detection and isolation strategy. Funding: No funding was received.

scholarly journals Infectivity of Adult and Pediatric COVID-19 Patients

2020 ◽  
Author(s):  
Mahir Kapmaz ◽  
Ozlem Dogan ◽  
Hacer Akturk ◽  
Berna Ozer ◽  
Elif Nurtop ◽  
...  
Keyword(s):  
Median Duration ◽  
Antibody Test ◽  
Viral Rna ◽  
Oral Transmission ◽  
Viral Shedding ◽  
Viral Culture ◽  
Positive Antibody ◽  
Hygiene Measures ◽  
Antibody Positivity ◽  
Test Result

Abstract We report infectivity of adult and pediatric COVID-19 patients in presence of viral shedding and anti-SARS-CoV-2 antibody response A total of 408 consequent samples from eleven adult and five pediatric patients with SARS-CoV-2 infection were included. The samples every second day from saliva, nasopharynx, feces, serum, urine, tear were studied by RT-PCR and viral culture. Anti-SARS-CoV-2 antibodies were measured. 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 onset of symptoms to admission was three days.The viral RNA was positive in 44.7 % of the nasopharynx and 37.6% of saliva samples up 16 days in adults and 19 days in chldren. The latest viral culture positivity was detected on day 8 of symptoms in nasopharynx. The viral RNA was found in 6.1% of feces, 4.4% ofserum, 4.3 % of tear, 2.9% of urine. The earliest seroconversion was the 7th day for adults and 8th day for children. Atthe 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. Earlier hospital admission could be associated with shorter SARS-CoV-2 RNA shedding. The infectivity of patient is very low after 8 days of symptoms. The risk of fecal-oral transmission is very low, and strict hand hygiene measures could be preventive. The positive antibody test result could be used as a discharge criterion.

scholarly journals Understanding viral shedding of severe acute respiratory coronavirus virus 2 (SARS-CoV-2): Review of current literature

2020 ◽  
pp. 1-10
Author(s):  
Lauren M. Fontana ◽  
Angela Holly Villamagna ◽  
Monica K. Sikka ◽  
Jessina C. McGregor
Keyword(s):  
Median Duration ◽  
Symptom Onset ◽  
Viral Rna ◽  
Infection Prevention And Control ◽  
Viral Shedding ◽  
Viral Culture ◽  
Discharge Management ◽  
Evidenced Based ◽  
And Control ◽  
Respiratory Coronavirus

Abstract 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; I2 = 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; I2 = 96.42%; P < .01) among severely ill patients and 17.2 days (95% CI, 14.0–20.5; I2 = 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.

scholarly journals Role of conformational heterogeneity in ligand recognition by viral RNA molecules

2021 ◽  
Author(s):  
Lev Levintov ◽  
Harish Vashisth
Keyword(s):  
Conformational Changes ◽  
Ribonucleic Acid ◽  
Viral Rna ◽  
Ligand Recognition ◽  
Conformational Heterogeneity ◽  
Rna Molecules ◽  
Environmental Stimuli

Ribonucleic acid (RNA) molecules are known to undergo conformational changes in response to various environmental stimuli including temperature, pH, and ligands. In particular, viral RNA molecules are a key example...

Prolonged Episodes of Hypoxemia in Preterm Infants Undetectable by Cardiorespiratory Monitors

PEDIATRICS ◽  
1995 ◽  
Vol 95 (6) ◽  
pp. 860-863 ◽  
Author(s):  
Christian F. Poets ◽  
Valerie A. Stebbens ◽  
David Richard ◽  
David P. Southall
Keyword(s):  
Heart Rate ◽  
Preterm Infants ◽  
Median Duration ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Prolonged Apnea ◽  
Gestational Age At Birth ◽  
Breathing Room ◽  
Age At Birth

Objective. To determine whether episodes of prolonged hypoxemia occur without prolonged apneic pauses (≥20 seconds) and without bradycardia (pulse rate, ≤100 beats per minute) in apparently well preterm infants. Methods. Long-term recordings of arterial oxygen saturation as measured by pulse oximetry (SpO2), photoplethysmographic (pulse) waveforms from the oximeter, and breathing movements were performed in 96 preterm infants (median gestational age at birth, 34 weeks; range, 28 to 36 weeks) who were breathing room air. Recordings started at a median age of 4 days (range, 1 to 60 days). Results. During a median duration of recording of 25 hours, 88 episodes in which SpO2 fell to 80% or less and remained there for 20 seconds or longer were identified in 15 infants. The median duration of these prolonged desaturations was 27 seconds (range, 20 to 81 seconds). In 73 episodes (83%), SpO2 continued to fall to 60% or less. Twenty-three desaturations were associated with prolonged apneic pauses and 54 with bradycardia; 19 of these were associated with both apnea and bradycardia. Thirty desaturations (34%; 10 infants) occurred without bradycardia and without prolonged apnea. Conclusions. These results indicate that a proportion of apparently well preterm infants exhibit episodes of severe prolonged hypoxemia unaccompanied by prolonged apneic pauses or bradycardia. Such episodes, therefore, would be difficult to detect if only breathing movements and heart rate are monitored. Indications for the use of oxygenation monitors in preterm infants should be reconsidered.

scholarly journals Quantitative measurement of infectious virus in SARS-CoV-2 Alpha, Delta and Epsilon variants reveals higher infectivity (viral titer:RNA ratio) in clinical samples containing the Delta and Epsilon variants.

2021 ◽  
Author(s):  
Hannah W Despres ◽  
Margaret G Mills ◽  
David J Shirley ◽  
Madaline M Schmidt ◽  
Meei-Li Huang ◽  
...  
Keyword(s):  
Quantitative Measurement ◽  
Infectious Virus ◽  
Viral Rna ◽  
Clinical Samples ◽  
Rt Pcr ◽  
Genome Copy ◽  
Live Virus ◽  
High Degree ◽  
The Relationship ◽  
Rna Levels

ABSTRACT Background Novel SARS-CoV-2 Variants of Concern (VoC) pose a challenge to controlling the COVID-19 pandemic. Previous studies indicate that clinical samples collected from individuals infected with the Delta variant may contain higher levels of RNA than previous variants, but the relationship between viral RNA and infectious virus for individual variants is unknown. Methods We measured infectious viral titer (using a micro-focus forming assay) as well as total and subgenomic viral RNA levels (using RT-PCR) in a set of 165 clinical samples containing SARS-CoV-2 Alpha, Delta and Epsilon variants that were processed within two days of collection from the patient. Results We observed a high degree of variation in the relationship between viral titers and RNA levels. Despite the variability we observed for individual samples the overall infectivity differed among the three variants. Both Delta and Epsilon had significantly higher infectivity than Alpha, as measured by the number of infectious units per quantity of viral E gene RNA (6 and 4 times as much, p=0.0002 and 0.009 respectively) or subgenomic E RNA (11 and 7 times as much, p<0.0001 and 0.006 respectively). Conclusion In addition to higher viral RNA levels reported for the Delta variant, the infectivity (amount of replication competent virus per viral genome copy) may also be increased compared to Alpha. Measuring the relationship between live virus and viral RNA is an important step in assessing the infectivity of novel SARS-CoV-2 variants. An increase in the infectivity of the Delta variant may further explain increased spread and suggests a need for increased measures to prevent viral transmission.

scholarly journals Association Between SARS-CoV-2 RNAemia and Post-Acute Sequelae of COVID-19.

2021 ◽  
Author(s):  
Nikhil Ram Mohan ◽  
David Kim ◽  
Angela J Rogers ◽  
Catherine A Blish ◽  
Kari C Nadeau ◽  
...  
Keyword(s):  
Disease Severity ◽  
Acute Phase ◽  
Viral Rna ◽  
Patient Demographics

Determinants of Post-Acute Sequelae of COVID-19 are not known. Here we show that 75% of patients with viral RNA in blood (RNAemia) at presentation were symptomatic in the post-acute phase. RNAemia at presentation successfully predicted PASC, independent of patient demographics, initial disease severity, and length of symptoms.

scholarly journals Duration of viral detection in throat and rectum of a patient with COVID-19

2020 ◽  
Author(s):  
Le Van Tan ◽  
Nghiem My Ngoc ◽  
Bui Thi Ton That ◽  
Le Thi Tam Uyen ◽  
Nguyen Thi Thu Hong ◽  
...  
Keyword(s):  
Infection Control ◽  
Patient Management ◽  
Ho Chi Minh City ◽  
Rt Pcr ◽  
Viral Detection ◽  
Oral Transmission ◽  
Viral Shedding ◽  
Clinical Recovery ◽  
Global Pandemic ◽  
Rapid Spread

AbstractThe rapid spread of coronavirus disease 2019 (COVID-19) raises concern about a global pandemic. Knowledge about the duration of viral shedding remains important for patient management and infection control. We report the duration of viral detection in throat and rectum of a COVID-19 patient treated at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam. Despite clinical recovery, SARS-CoV-2 RNA remained detectable by real time RT-PCR in throat and rectal swabs until day 11 and 18 of hospitalization, respectively. Because live SARS-CoV-2 has been successfully isolated from a stool sample from a COVID-19 patient in China, the results demonstrate that COVID-19 patients may remain infectious for long periods, and fecal-oral transmission may be possible. Therefore, our finding has important implications for infection control.

scholarly journals Ebola Virus Ribonucleic Acid Detection in Semen More Than Two Years After Resolution of Acute Ebola Virus Infection

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
William A Fischer ◽  
Jerry Brown ◽  
David Alain Wohl ◽  
Amy James Loftis ◽  
Sam Tozay ◽  
...  
Keyword(s):  
Virus Infection ◽  
Ribonucleic Acid ◽  
Ebola Virus ◽  
Infectious Virus ◽  
Virus Disease ◽  
Viral Rna ◽  
Ebola Virus Disease ◽  
Positive Specimen ◽  
Ebola Virus Infection

Abstract Among 149 men who survived Ebola virus disease (EVD) and donated semen 260–1016 days after EVD onset, Ebola virus (EBOV) ribonucleic acid (RNA) was detected in 13 (9%). Of 137 men who donated semen 2 years after EVD onset, 11 (8%) had an EBOV RNA-positive specimen. The mechanism underlying the persistence of EBOV RNA in semen is unclear, and it is unclear whether the detection of viral RNA represents the presence of infectious virus.

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