Inferred duration of infectious period of SARS-CoV-2: rapid scoping review and analysis of available evidence for asymptomatic and symptomatic COVID-19 cases

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Title: Inferred duration of infectious period of SARS-CoV-2: rapid scoping review and analysis of available evidence for asymptomatic and symptomatic COVID-19 cases
Authors: Byrne, Andrew W.McEvoy, DavidCollins, Áine B.Hunt, KevinCasey, MiriamBarber, AnnButler, FrancisLane, ElizabethMcAloon, Conor G.Wall, Patrick G.More, Simon Johnet al.
Permanent link: http://hdl.handle.net/10197/11464
Date: 1-Aug-2020
Online since: 2020-08-11T12:15:35Z
Abstract: Objectives. Our objective was to review the literature on the inferred duration of the infectious period of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, and provide an overview of the variation depending on the methodological approach. Design. Rapid scoping review. Literature review with fixed search terms, up to 1 April 2020. Central tendency and variation of the parameter estimates for infectious period in (A) asymptomatic and (B) symptomatic cases from (1) virological studies (repeated testing), (2) tracing studies and (3) modelling studies were gathered. Narrative review of viral dynamics. Information sources. Search strategies developed and the following searched: PubMed, Google Scholar, MedRxiv and BioRxiv. Additionally, the Health Information Quality Authority (Ireland) viral load synthesis was used, which screened literature from PubMed, Embase, ScienceDirect, NHS evidence, Cochrane, medRxiv and bioRxiv, and HRB open databases. Results. There was substantial variation in the estimates, and how infectious period was inferred. One study provided approximate median infectious period for asymptomatic cases of 6.5–9.5 days. Median presymptomatic infectious period across studies varied over <1–4 days. Estimated mean time from symptom onset to two negative RT-PCR tests was 13.4 days (95% CI 10.9 to 15.8) but was shorter when studies included children or less severe cases. Estimated mean duration from symptom onset to hospital discharge or death (potential maximal infectious period) was 18.1 days (95% CI 15.1 to 21.0); time to discharge was on average 4 days shorter than time to death. Viral dynamic data and model infectious parameters were often shorter than repeated diagnostic data. Conclusions. There are limitations of inferring infectiousness from repeated diagnosis, viral loads and viral replication data alone and also potential patient recall bias relevant to estimating exposure and symptom onset times. Despite this, available data provide a preliminary evidence base to inform models of central tendency for key parameters and variation for exploring parameter space and sensitivity analysis.
Type of material: Journal Article
Publisher: BMJ Journals
Journal: BMJ Open
Volume: 10
Issue: 8
Start page: e039856
End page: e039856
Copyright (published version): 2020 the Authors
Keywords: COVID-19CoronavirusInfectious periodVirological studiesContact tracingModelling
DOI: 10.1136/bmjopen-2020-039856
Other versions: https://doi.org/10.1101/2020.04.25.20079889
Language: en
Status of Item: Peer reviewed
Appears in Collections:Biosystems and Food Engineering Research Collection
Public Health, Physiotherapy and Sports Science Research Collection
Veterinary Medicine Research Collection
CVERA Research Collection

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