Delayed SARS-COV-2 clearance in infected persons in Ghana

Objective: This study aimed to determine the duration of SARS-CoV-2 clearance in persons in Ghana. The research question was whether the duration of virus clearance in Ghana matched the 14 days recommended by the World Health Organization (WHO); this had direct implications for transmission, which was key in managing the COVID-19 pandemic. Design: This was a retrospective analytical study. Setting: All facilities that submitted clinical specimens to Noguchi Memorial Institute for Medical Research (NMIMR) for SARS-CoV-2 diagnosis between March to June 2020 were included in the study. Interventions: Samples from 480 persons who tested positive for SARS-CoV-2 by RT-PCR from March to June 2020 at NMIMR and submitted at least two follow-up samples were retrospectively analysed. Individuals with two consecutive negative RT-PCR retesting results were considered to have cleared SARS-CoV-2. Results: The median time from the initial positive test to virus clearance was 20 days (IQR: 5-56 days). This was six days longer than the WHO-recommended 14 days, after which infected persons could be de-isolated. Sputum and nasopharyngeal swabs proved more sensitive for detecting viral RNA as the infection progressed. At a significance level of 0.05, age and sex did not seem to influence the time to SARS-CoV-2 clearance. Conclusions: The median time to SARS-CoV-2 clearance in this study was 20 days, suggesting that SARS-CoV-2 infected persons in Ghana take longer to clear the virus. This finding calls for further investigations into whether patients who remain PCR positive continue to be infectious and inform isolation practices in Ghana.

Coronaviruses: a review of their properties and diversity

Human coronaviruses, which hitherto were causative agents of mild respiratory diseases of man, have recently become one of the most important groups of pathogens of humans the world over. In less than two decades, three members of the group, severe acute respiratory syndrome (SARS) coronavirus (CoV), Middle East respiratory syndrome (MERS)-CoV, and SARS-COV-2, have emerged causing disease outbreaks that affected millions and claimed the lives of thousands of people. In 2017, another coronavirus, the swine acute diarrhea syndrome (SADS) coronavirus (SADS-CoV) emerged in animals killing over 24,000 piglets in China. Because of the medical and veterinary importance of coronaviruses, we carried out a review of available literature and summarized the current information on their properties and diversity. Coronaviruses are single-stranded RNA viruses with some unique characteristics such as the possession of a very large nucleic acid, high infidelity of the RNA-dependent polymerase, and high rate of mutation and recombination in the genome. They are susceptible to a number of physical agents and several chemical agents used for disinfection procedures in hospitals and laboratories. They exhibit considerable genetic and host diversity, causing diseases of gastrointestinal and respiratory system in a wide range of vertebrate hosts including humans. The high prevalence of coronaviruses in domestic and wild animals, especially bats and birds, and the propensity for their genomes to undergo mutation and recombination may lead to emergence of new coronaviruses that could pose a serious threat to human and animal health