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Abstract

Coronavirus disease 2019 (COVID-19) is transmitted person-to-person mainly by close contact or droplets from respiratory tract. However, the actual time of viral shedding is still uncertain as well as the different routes of transmission. We aimed to characterize RNA shedding from nasopharyngeal and rectal samples in prolonged cases of mild COVID-19 in young male soldiers. Seventy patients from three different military locations were monitored after recommending to follow more strict isolation measures to prevent the spread of the virus. Then, nasopharyngeal, rectal, and blood samples were taken. SARS-CoV-2 RNA was detected by RT-PCR and specific antibodies by chemiluminescent immunoassays. The median nucleic acid conversion time (NACT) was 60 days (IQR: 7–85 days). Rectal swabs were taken in 60 % of patients. Seven patients (10 %) were positive in nasopharyngeal and rectal swabs, and five (7.14 %) remained positive in rectal swabs, but negative in nasopharyngeal samples. Four patients (5.71 %) that had been discharged, were positive again after 15 days. No significant difference was found in nucleic acid conversion time between age groups nor clinical classification. Maintaining distancing among different positive patients is essential as a possible re-exposure to the virus could cause a longer nucleic acid conversion time in SARS-COV-2 infections.

Funding
This study was supported by the:
  • Instituto Nacional de Salud, Colombia
    • Principle Award Recipient: NotApplicable
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. The Microbiology Society waived the open access fees for this article.
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/content/journal/jmm/10.1099/jmm.0.001498
2022-01-31
2024-05-02
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References

  1. Zhou P, Yang X-L, Wang X-G, Hu B, Zhang L et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579:270–273 [View Article] [PubMed]
    [Google Scholar]
  2. Helmy YA, Fawzy M, Elaswad A, Sobieh A, Kenney SP et al. The COVID-19 pandemic: a comprehensive review of taxonomy, genetics, epidemiology, diagnosis, treatment, and coPandemic: A Comprehensive Review of Taxonomy, Genetics, Epidemiology, Diagnosis, Treatment, and Control. J Clin Med 2020; 9:E1225 [View Article] [PubMed]
    [Google Scholar]
  3. Chan J-W, Yuan S, Kok K-H, To K-W, Chu H et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. The Lancet 2020; 395:514–523 [View Article]
    [Google Scholar]
  4. Nakajima Y, Ogai A, Furukawa K, Arai R, Anan R et al. Prolonged viral shedding of SARS-CoV-2 in an immunocompromised patient. J Infect Chemother 2021; 27:387–389 [View Article] [PubMed]
    [Google Scholar]
  5. Chirathaworn C, Sripramote M, Chalongviriyalert P, Jirajariyavej S, Kiatpanabhikul P et al. SARS-CoV-2 RNA shedding in recovered COVID-19 cases and the presence of antibodies against SARS-CoV-2 in recovered COVID-19 cases and close contacts, Thailand, April-June 2020. PLoS One 2020; 15:e0236905 [View Article]
    [Google Scholar]
  6. Tan L, Kang X, Zhang B, Zheng S, Liu B et al. medRxiv 20202020.03.22.20040071 [View Article]
    [Google Scholar]
  7. Zhou C, Zhang T, Ren H, Sun S, Yu X et al. Impact of age on duration of viral RNA shedding in patients with COVID-19. Aging 2020; 12:22399–22404 [View Article]
    [Google Scholar]
  8. Chang D, Mo G, Yuan X, Tao Y, Peng X et al. Time kinetics of viral clearance and resolution of symptoms in novel coronavirus infection. Am J Respir Crit Care Med 2020; 201:1150–1152 [View Article] [PubMed]
    [Google Scholar]
  9. Abrahim SA, Tessema M, Defar A, Hussen A, Ejeta E et al. Time to recovery and its predictors among adults hospitalized with COVID-19: A prospective cohort study in Ethiopia. PLoS One 2020; 15:e0244269 [View Article]
    [Google Scholar]
  10. Xue J, Zheng J, Shang X, Qin E, Zhao P et al. Risk factors for prolonged viral clearance in adult patients with COVID-19 in Beijing, China: A prospective observational study. Int Immunopharmacol 2020; 89:107031 [View Article]
    [Google Scholar]
  11. Xiao AT, Tong YX, Zhang S. False negative of RT-PCR and prolonged nucleic acid conversion in COVID-19: Rather than recurrence. J Med Virol 2020; 92:1755–1756 [View Article] [PubMed]
    [Google Scholar]
  12. Lin P, Chen W, Huang H, Lin Y, Cai M et al. Delayed discharge is associated with higher complement C3 levels and a longer nucleic acid-negative conversion time in patients with COVID-19. Sci Rep 2021; 11:1233 [View Article] [PubMed]
    [Google Scholar]
  13. Zhang Y, Chen C, Song Y, Zhu S, Wang D et al. Excretion of SARS-CoV-2 through faecal specimens. Emerg Microbes Infect 2020; 9:2501–2508 [View Article] [PubMed]
    [Google Scholar]
  14. Tepekule B, Hauser A, Kachalov VN, Andresen S, Scheier T et al. Assessing the potential impact of transmission during prolonged viral shedding on the effect of lockdown relaxation on COVID-19. PLoS Comput Biol 2021; 17:e1008609 [View Article] [PubMed]
    [Google Scholar]
  15. Instituto Nacional de Salud Validación secundaria y verificación del desempeño de la prueba serológica “SARS-CoV-2 IgG para uso en Architect – Abbott.”. National Institute of Health; 2020 https://www.ins.gov.co/BibliotecaDigital/validacion-prueba-serologica-sars-CoV-2-Igg-architect-Abbott.pdf
  16. Albans S, Griffiths E, Knezevic I, Mattiuzzo G, Page M et al. WHO international standard for evaluation of the antibody response to covid-19 vaccines: call for urgent action by the scientific community. The Lancet Microbe 2021S2666-5247(21)00266-4
    [Google Scholar]
  17. Liu W-D, Chang S-Y, Wang J-T, Tsai M-J, Hung C-C et al. Prolonged virus shedding even after seroconversion in a patient with COVID-19. J Infect 2020; 81:318–356 [View Article] [PubMed]
    [Google Scholar]
  18. Zhang W, Yu L, Huang J, Zeng D-X. Prolonged vViral RNA shedding duShedding Duration in COVID-19. Am J Ther 202010.1097/MJT.0000000000001200 [View Article] [PubMed]
    [Google Scholar]
  19. Zhou F, Yu T, Du R, Fan G, Liu Y et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395:1054–1062 [View Article] [PubMed]
    [Google Scholar]
  20. Kipkorir V, Cheruiyot I, Ngure B, Misiani M, Munguti J. Prolonged SARS-CoV-2 RNA detection in anal/rectal swabs and stool specimens in COVID-19 patients after negative conversion in nasopharyngeal RT-PCR test. J Med Virol 2020; 92:2328–2331 [View Article] [PubMed]
    [Google Scholar]
  21. Xiao AT, Tong YX, Zhang S. Profile of RT-PCR for SARS-CoV-2: A preliminary study from 56 COVID-19 patients. Clin Infect Dis 2020; 71:2249–2251 [View Article] [PubMed]
    [Google Scholar]
  22. Somsen GA, van Rijn C, Kooij S, Bem RA, Bonn D. Small droplet aerosols in poorly ventilated spaces and SARS-CoV-2 transmission. Lancet Respir Med 2020; 8:658–659 [View Article] [PubMed]
    [Google Scholar]
  23. Smith SH, Somsen GA, van Rijn C, Kooij S, van der Hoek L et al. Aerosol persistence in relation to possible transmission of SARS-CoV-2. Phys Fluids 2020; 32:107108 [View Article] [PubMed]
    [Google Scholar]
  24. Zhang J-F, Yan K, Ye H-H, Lin J, Zheng J-J et al. SARS-CoV-2 turned positive in a discharged patient with COVID-19 arouses concern regarding the present standards for discharge. Int J Infect Dis 2020; 97:212–214 [View Article] [PubMed]
    [Google Scholar]
  25. Pirnay J-P, Selhorst P, Cochez C, Petrillo M, Claes V et al. Study of a SARS-CoV-2 Outbreak in a Belgian Military Education and Training Center in Maradi, Niger. Viruses 2020; 12:E949 [View Article] [PubMed]
    [Google Scholar]
  26. Li Q, Guan X, Wu P, Wang X, Zhou L et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med 2020; 382:1199–1207 [View Article]
    [Google Scholar]
  27. Xu K, Chen Y, Yuan J, Yi P, Ding C et al. Factors Associated With Prolonged Viral RNA Shedding in Patients with Coronavirus Disease 2019 (COVID-19). Clin Infect Dis 2020; 71:799–806 [View Article] [PubMed]
    [Google Scholar]
  28. Giefing-Kröll C, Berger P, Lepperdinger G, Grubeck-Loebenstein B. How sex and age affect immune responses, susceptibility to infections, and response to vaccination. Aging Cell 2015; 14:309–321 [View Article] [PubMed]
    [Google Scholar]
  29. Chan JF-W, Yuan S, Kok K-H, To KK-W, Chu H et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020; 395:514–523 [View Article] [PubMed]
    [Google Scholar]
  30. Wölfel R, Corman VM, Guggemos W, Seilmaier M, Zange S et al. Virological assessment of hospitalized patients with COVID-2019. Nature 2020; 581:465–469 [View Article] [PubMed]
    [Google Scholar]
  31. Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J et al. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med 2020; 382:929–936 [View Article] [PubMed]
    [Google Scholar]
  32. Zhang W, Du R-H, Li B, Zheng X-S, Yang X-L et al. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect 2020; 9:386–389 [View Article] [PubMed]
    [Google Scholar]
  33. Xu Y, Li X, Zhu B, Liang H, Fang C et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med 2020; 26:502–505 [View Article] [PubMed]
    [Google Scholar]
  34. Wang W, Xu Y, Gao R, Lu R, Han K et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA 2020; 323:1843–1844 [View Article] [PubMed]
    [Google Scholar]
  35. Sah R, Rodriguez-Morales AJ, Jha R, Chu DKW, Gu H et al. Complete Genome Sequence of a 2019 Novel Coronavirus (SARS-CoV-2) Strain Isolated in Nepal. Microbiol Resour Announc 2020; 9:e00169-20 [View Article] [PubMed]
    [Google Scholar]
  36. Alsaud AE, Nair AP, Matarneh AS, Sasi S, El Hassan R et al. Case Report: Prolonged Viral Shedding in Six COVID-19 Patients. Am J Trop Med Hyg 2021tpmd200933 [View Article] [PubMed]
    [Google Scholar]
  37. Bullard J, Dust K, Funk D, Strong JE, Alexander D et al. Predicting Infectious Severe Acute Respiratory Syndrome Coronavirus 2 From Diagnostic Samples. Clin Infect Dis 2020; 71:2663–2666 [View Article] [PubMed]
    [Google Scholar]
  38. Falsey AR, Formica MA, Treanor JJ, Walsh EE. Comparison of quantitative reverse transcription-PCR to viral culture for assessment of respiratory syncytial virus shedding. J Clin Microbiol 2003; 41:4160–4165 [View Article] [PubMed]
    [Google Scholar]
  39. Zhang B, Liu S, Dong Y, Zhang L, Zhong Q et al. Positive rectal swabs in young patients recovered from coronavirus disease 2019 (COVID-19). J Infect 2020; 81:e49–e52 [View Article] [PubMed]
    [Google Scholar]
  40. Lan L, Xu D, Ye G, Xia C, Wang S et al. Positive RT-PCR Test Results in Patients Recovered From COVID-19. JAMA 2020; 323:1502–1503 [View Article] [PubMed]
    [Google Scholar]
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