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Detection and viral RNA shedding of SARS-CoV-2 in respiratory specimens relative to symptom onset among COVID-19 patients in Bavaria, Germany.
Woudenberg, Tom; Eberle, Ute; Marosevic, Durdica; Liebl, Bernhard; Ackermann, Nikolaus; Katz, Katharina; Sing, Andreas.
  • Woudenberg T; Unit of Infectious Diseases Epidemiology, Bavarian Health and Food Safety Authority, Oberschleissheim, Germany.
  • Eberle U; ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
  • Marosevic D; Unit of Virology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany.
  • Liebl B; Unit of Infectious Diseases Epidemiology, Bavarian Health and Food Safety Authority, Oberschleissheim, Germany.
  • Ackermann N; State Institute of Health, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany.
  • Katz K; Ludwig Maximilians-Universität, Munich, Germany.
  • Sing A; Unit of Virology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany.
Epidemiol Infect ; 149: e150, 2021 06 23.
Article in English | MEDLINE | ID: covidwho-1338505
ABSTRACT
We assessed severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (RT-PCR) diagnostic sensitivity and cycle threshold (Ct) values relative to symptom onset in symptomatic coronavirus disease-2019 (COVID-19) patients from Bavaria, Germany, of whom a subset was repeatedly tested. Locally weighted scatterplot smoothing method was used to assess the relationship between symptom onset and Ct-values. Kaplan-Meier plots were used to visualise the empirical probability of detecting viral ribonucleic acid (RNA) over time and estimate the time until clearance of viral RNA among the repeatedly tested patients. Among 721 reported COVID-19 cases, the viral RNA was detected in specimens taken between three days before and up to 48 days after symptom onset. The mean Ct-value was 28.6 (95% confidence interval (CI) 28.2-29.0) with the lowest mean Ct-value (26.2) observed two days after symptom onset. Up to 7 days after symptom onset, the diagnostic sensitivity of the RT-PCR among repeatedly sampled patients (n = 208) remained above 90% and decreased to 50% at day 12 (95% CI 10.5-21.5). Our data provide valuable estimates to optimise the timing of sampling of individuals for SARS-CoV-2 detection. A considerable proportion of specimens sampled before symptom onset had Ct-values comparable with Ct-values after symptom onset, suggesting the probability of presymptomatic transmission.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Virus Shedding / SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Experimental Studies Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Epidemiol Infect Journal subject: Communicable Diseases / Epidemiology Year: 2021 Document Type: Article Affiliation country: S0950268821001345

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Virus Shedding / SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Experimental Studies Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Epidemiol Infect Journal subject: Communicable Diseases / Epidemiology Year: 2021 Document Type: Article Affiliation country: S0950268821001345