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SARS-CoV-2 Carrying Time Averages 4 Weeks in Inpatients
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Mark Mascolini
People admitted to the hospital in Henan, China with SARS-CoV-2 infection carried the virus for an average 4 weeks, according to a 161-person analysis [1]. The longest carrying time reached 50 days. The authors concluded that "COVID-19 disease may have the characteristics of longer infectivity and stronger infectivity than SARS" [severe acute respiratory syndrome].
Henan province in east central China lies just north of Hubei province, the initial epicenter of the COVID-19 epidemic. To estimate SARS-CoV-2 carrying time, Henan researchers conducted this retrospective study of people admitted to the hospital from January 20 to March 1, 2020 with a positive SARS-CoV-2 nucleic acid test and a specific SARS-CoV-2 epidemiologic history. They defined viral carrying time as "the time from a close contact with the source of infection to the last positive test for COVID-19 virus."
The Henan team divided participants by age, gender, and COVID-19 severity (severe and nonsevere). Of the 161 inpatients analyzed, 89 (55%) were men, median age stood at 44 years (range 2 to 94), and 37 people (23%) had severe COVID-19.
Overall median SARS-CoV-2 carrying time stood at 26 days and ranged from 6 to 50 days. Men had a median carrying time of 21 days (interquartile range [IQR] 16.5 to 29 days), a duration that did not vary significantly from a median of 20 days (IQR 16 to 26.8) in women.
Among 126 people (78%) up to 59 years old, median carrying time measured 20 days (IQR 16 to 28), compared with 28 days (IQR 19 to 33) for people 60 or older, a significant difference (P < 0.01).
People with nonsevere COVID-19 carried SARS-CoV-2 for a median of 20 days (IQR 16 to 26), compared with 27 days (IQR 19 to 33) in the severe group, also a significant difference (P < 0.01).
The authors attributed the strong infectivity of SARS-CoV-2 to (1) transmission via the respiratory tract and (2) transmission during viral incubation, during asymptomatic infection, and during typical or atypical symptoms. The long persistence of SARS-CoV-2 despite diagnosis, hospital admission, and treatment "could contribute to a worse disease and poor prognosis" and "may serve as the consideration for the continued exacerbation of the condition in elderly and severe patients over 60 years of age."
Reference
1. Du X, Yu X, Li Q, et al. Duration for carrying SARS-CoV-2 in COVID-19 patients. J Infect. 2020. doi: https://doi.org/10.1016/j.jinf.2020.03.053
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