Prolonged viral RNA shedding after COVID-19 symptom resolution in older convalescent plasma donors

ABSTRACT

ImportanceThe novel coronavirus, SARS-CoV-2, is responsible for a world-wide pandemic. While the medical community understands the mode of viral transmission, less is known about how long viral shedding occurs once viral symptoms have resolved. ObjectiveTo determine how long the SARS-CoV-2 remains detectable following self-reporting of viral symptom resolution. DesignA cohort of 86 previously SARS-CoV-2 positive patients were re-tested for proof of viral recovery by nasal swab and nucleic acid amplification less than 28 days after self-reported symptom resolution. This study was approved by the University of Wisconsin Institutional Review Board. SettingA tertiary care center in a mid-size city utilizing a drive-through SAR-CoV-2 testing center. Participants86 previously confirmed SARS-CoV-2 positive individuals less than 28 days after self-reported resolution of symptoms evaluated as potential donors for COVID-19 convalescent plasma. InterventionParticipants underwent nasopharyngeal sampling and subsequent nucleic acid amplification for SARS-CoV-2 genes. Main OutcomeSARS-CoV-2 RNA in nasopharyngeal secretions detected by rtPCR. Results11/86 (13%) previously confirmed SARS-CoV-2 subjects were still positive at a median of 19 days (range 12-24 days) after symptom resolution. Older patients were more likely to be test-positive, and older positive patients had lower rtPCR CT values. Test-positive patients were not significantly different from test-negative patients with respect to days since symptom recovery. Conclusions and ResolutionThese results underscore the necessity of testing COVID-19 convalescent plasma donors less than 28 days after symptom resolution and suggests that COVID-19 positive patients may need to remain in quarantine beyond the recommended two weeks following "recovery." Trial Registrationn/a