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Standard testing for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is based on RT-PCR tests, but detection of viral genetic material alone does not indicate ongoing infectious potential. The ability to isolate whole virus represents a better proxy for infectivity.


The objective of this study was to gain an understanding of the current literature and compare the reported periods of positive SARS-CoV-2 detection from studies that conducted RT-PCR testing in addition to experiments isolating whole virus.


Using a rapid review approach, studies reporting empirical data on the duration of positive RT-PCR results and/or successful viral isolation following SARS-CoV-2 infection in humans were identified through searches of peer-reviewed and pre-print health sciences literature. Articles were screened for relevance, then data were extracted, analysed, and synthesised.


Of the 160 studies included for qualitative analysis, 84% (n = 135) investigated duration of positive RT-PCR tests only, 5% (n = 8) investigated duration of successful viral isolations, while 11% (n = 17) included measurements on both. There was significant heterogeneity in reported data. There was a prolonged time to viral clearance when deduced from RT-PCR tests compared with viral isolations (median: 26 vs 9 days).


Findings from this review support a minimum 10-day period of isolation but certain cases where virus was isolated after 10 days were identified. Given the extended time to viral clearance from RT-PCR tests, future research should ensure standard reporting of RT-PCR protocols and results to help inform testing policies aimed at clearance from isolation.


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  1. Joynt GM, Wu WK. Understanding COVID-19: what does viral RNA load really mean? Lancet Infect Dis. 2020;20(6):635-6.  https://doi.org/10.1016/S1473-3099(20)30237-1  PMID: 32224308 
  2. Byrne AW, McEvoy D, Collins AB, Hunt K, Casey M, Barber A, et al. Inferred duration of infectious period of SARS-CoV-2: rapid scoping review and analysis of available evidence for asymptomatic and symptomatic COVID-19 cases. BMJ Open. 2020;10(8):e039856.  https://doi.org/10.1136/bmjopen-2020-039856  PMID: 32759252 
  3. Fontana LM, Villamagna AH, Sikka MK, McGregor JC. Understanding viral shedding of severe acute respiratory coronavirus virus 2 (SARS-CoV-2): Review of current literature. Infect Control Hosp Epidemiol. 2020;1-10.  https://doi.org/10.1017/ice.2020.1273  PMID: 33077007 
  4. Jefferson T, Spencer EA, Brassey J, Heneghan C. Viral cultures for COVID-19 infectious potential assessment – a systematic review. Clin Infect Dis. 2020;ciaa1764.
  5. Morone G, Palomba A, Iosa M, Caporaso T, De Angelis D, Venturiero V, et al. Incidence and persistence of viral shedding in COVID-19 post-acute patients with negativized pharyngeal swab: a systematic review. Front Med (Lausanne). 2020;7:562.  https://doi.org/10.3389/fmed.2020.00562  PMID: 32984389 
  6. Weiss A, Jellingsø M, Sommer MOA. Spatial and temporal dynamics of SARS-CoV-2 in COVID-19 patients: A systematic review and meta-analysis. EBioMedicine. 2020;58:102916.  https://doi.org/10.1016/j.ebiom.2020.102916  PMID: 32711256 
  7. Walsh KA, Spillane S, Comber L, Cardwell K, Harrington P, Connell J, et al. The duration of infectiousness of individuals infected with SARS-CoV-2. J Infect. 2020;81(6):847-56.  https://doi.org/10.1016/j.jinf.2020.10.009  PMID: 33049331 
  8. World Health Organization (WHO). Criteria for releasing COVID-19 patients from isolation. Geneva: WHO; 2020 Jun. Available from: https://www.who.int/publications-detail-redirect/criteria-for-releasing-covid-19-patients-from-isolation
  9. Jefferson T, Spencer E, Brassey J, Heneghan C. Viral cultures for COVID-19 infectivity assessment. Systematic review. medRxiv. 2020 Sep 29;2020.08.04.20167932.
  10. Lu J, Peng J, Xiong Q, Liu Z, Lin H, Tan X, et al. Clinical, immunological and virological characterization of COVID-19 patients that test re-positive for SARS-CoV-2 by RT-PCR. medRxiv. 2020 Jun 17;2020.06.15.20131748.
  11. Liu W-D, Chang S-Y, Wang J-T, Tsai M-J, Hung C-C, Hsu C-L, et al. Prolonged virus shedding even after seroconversion in a patient with COVID-19. J Infect. 2020;81(2):318-56.  https://doi.org/10.1016/j.jinf.2020.03.063  PMID: 32283147 
  12. Cao H, Ruan L, Liu J, Liao W. The clinical characteristic of eight patients of COVID-19 with positive RT-PCR test after discharge. J Med Virol. 2020;92(10):2159-64.  https://doi.org/10.1002/jmv.26017  PMID: 32410245 
  13. Chen J, Xu X, Hu J, Chen Q, Xu F, Liang H, et al. Clinical Course and Risk Factors for Recurrence of Positive SARS-CoV-2 RNA: A Retrospective Cohort Study from Wuhan, China. medRxiv. 2020 May 12;2020.05.08.20095018.
  14. Li J, Zhang L, Liu B, Song D. Case report: viral shedding for 60 days in a woman with COVID-19. Am J Trop Med Hyg. 2020;102(6):1210-3.  https://doi.org/10.4269/ajtmh.20-0275  PMID: 32342849 
  15. Yang JR, Deng DT, Wu N, Yang B, Li HJ, Pan XB. Persistent viral RNA positivity during the recovery period of a patient with SARS-CoV-2 infection. J Med Virol. 2020;92(9):1681-3.  https://doi.org/10.1002/jmv.25940  PMID: 32330293 
  16. Man Z, Jing Z, Huibo S, Bin L, Fanjun Z. Viral shedding prolongation in a kidney transplant patient with COVID-19 pneumonia. Am J Transplant. 2020;20(9):2626-7.  https://doi.org/10.1111/ajt.15996  PMID: 32400931 
  17. Dobbins M. Rapid review guidebook. Hamilton, ON: National Collaborating Centre for Methods and Tools. Hamilton: National Collaborating Centre for Methods and Tools; 2017. Available from: https://www.nccmt.ca/capacity-development/rapid-review-guidebook
  18. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.  https://doi.org/10.1371/journal.pmed.1000097  PMID: 19621072 
  19. Hong QN, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, et al. The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Educ Inf. 2018;34(4):285-91.  https://doi.org/10.3233/EFI-180221 
  20. R Core Team. R: A language and environment for statistical computing. Vienna, Austria; 2020. Available from: http://www.R-project.org/
  21. Decker A, Welzel M, Laubner K, Grundmann S, Kochs G, Panning M, et al. Prolonged SARS-CoV-2 shedding and mild course of COVID-19 in a patient after recent heart transplantation. Am J Transplant. 2020;20(11):3239-45.  https://doi.org/10.1111/ajt.16133  PMID: 32519406 
  22. Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR, et al. Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility. N Engl J Med. 2020;382(22):2081-90.  https://doi.org/10.1056/NEJMoa2008457  PMID: 32329971 
  23. Million M, Lagier JC, Gautret P, Colson P, Fournier PE, Amrane S, et al. Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France. Travel Med Infect Dis. 2020;35:101738.  https://doi.org/10.1016/j.tmaid.2020.101738  PMID: 32387409 
  24. Kumar DS, O’Neill SB, Johnston JC, Grant JM, Sweet DD. SARS-CoV-2 infection in a 76-year-old man with initially negative results for nasopharyngeal swabs. CMAJ. 2020;192(20):E546-9.  https://doi.org/10.1503/cmaj.200641  PMID: 32332041 
  25. Bullard J, Dust K, Funk D, Strong JE, Alexander D, Garnett L, et al. Predicting infectious severe acute respiratory syndrome coronavirus 2 from diagnostic samples. Clin Infect Dis. 2020;71(10):2663-6.  https://doi.org/10.1093/cid/ciaa638  PMID: 32442256 
  26. COVID-19 Investigation Team. Clinical and virologic characteristics of the first 12 patients with coronavirus disease 2019 (COVID-19) in the United States. Nat Med. 2020;26(6):861-8.  https://doi.org/10.1038/s41591-020-0877-5  PMID: 32327757 
  27. Lescure FX, Bouadma L, Nguyen D, Parisey M, Wicky PH, Behillil S, et al. Clinical and virological data of the first cases of COVID-19 in Europe: a case series. Lancet Infect Dis. 2020;20(6):697-706.  https://doi.org/10.1016/S1473-3099(20)30200-0  PMID: 32224310 
  28. Kim JY, Ko JH, Kim Y, Kim YJ, Kim JM, Chung YS, et al. Viral load kinetics of SARS-CoV-2 infection in first two patients in Korea. J Korean Med Sci. 2020;35(7):e86.  https://doi.org/10.3346/jkms.2020.35.e86  PMID: 32080991 
  29. Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Sevestre J, et al. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study. Travel Med Infect Dis. 2020;34:101663.  https://doi.org/10.1016/j.tmaid.2020.101663  PMID: 32289548 
  30. Haveri A, Smura T, Kuivanen S, Österlund P, Hepojoki J, Ikonen N, et al. Serological and molecular findings during SARS-CoV-2 infection: the first case study in Finland, January to February 2020. Euro Surveill. 2020;25(11):2000266.  https://doi.org/10.2807/1560-7917.ES.2020.25.11.2000266  PMID: 32209163 
  31. Liu WD, Chang SY, Wang JT, Tsai MJ, Hung CC, Hsu CL, et al. Prolonged virus shedding even after seroconversion in a patient with COVID-19. J Infect. 2020;81(2):318-56. PMID: 32283147 
  32. Perera RAPM, Tso E, Tsang OTY, Tsang DNC, Fung K, Leung YWY, et al. SARS-CoV-2 virus culture and subgenomic RNA for respiratory specimens from patients with mild coronavirus disease. Emerg Infect Dis. 2020;26(11):2701-4.  https://doi.org/10.3201/eid2611.203219  PMID: 32749957 
  33. Wölfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Müller MA, et al. Virological assessment of hospitalized patients with COVID-2019. Nature. 2020;581(7809):465-9.  https://doi.org/10.1038/s41586-020-2196-x  PMID: 32235945 
  34. Young BE, Ong SWX, Ng LFP, Anderson DE, Chia WN, Chia PY, et al. Viral dynamics and immune correlates of COVID-19 disease severity. Clin Infect Dis. 2020;ciaa1280.  https://doi.org/10.1093/cid/ciaa1280  PMID: 32856707 
  35. Chang D, Zhao P, Zhang D, Dong JH, Xu Z, Yang G, et al. Persistent viral presence determines the clinical course of the disease in COVID-19. J Allergy Clin Immunol Pract. 2020;8(8):2585-2591.e1.  https://doi.org/10.1016/j.jaip.2020.06.015  PMID: 32574840 
  36. Sun J, Zhu A, Li H, Zheng K, Zhuang Z, Chen Z, et al. Isolation of infectious SARS-CoV-2 from urine of a COVID-19 patient. Emerg Microbes Infect. 2020;9(1):991-3.  https://doi.org/10.1080/22221751.2020.1760144  PMID: 32342724 
  37. Kim JM, Kim HM, Lee EJ, Jo HJ, Yoon Y, Lee NJ, et al. Detection and isolation of SARS-CoV-2 in serum, urine, and stool specimens of COVID-19 patients from the Republic of Korea. Osong Public Health Res Perspect. 2020;11(3):112-7.  https://doi.org/10.24171/j.phrp.2020.11.3.02  PMID: 32528816 
  38. van Kampen JJA, van de Vijver DAMC, Fraaij PLA, Haagmans BL, Lamers MM, Okba N, et al. Shedding of infectious virus in hospitalized patients with coronavirus disease-2019 (COVID-19): duration and key determinants. medRxiv. 2020 Jun 9;2020.06.08.20125310.
  39. Singanayagam A, Patel M, Charlett A, Lopez Bernal J, Saliba V, Ellis J, et al. Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020. Euro Surveill. 2020;25(32):2001483.  https://doi.org/10.2807/1560-7917.ES.2020.25.32.2001483  PMID: 32794447 
  40. Gniazdowski V, Morris CP, Wohl S, Mehoke T, Ramakrishnan S, Thielen P, et al. Repeat COVID-19 molecular testing: correlation with recovery of infectious virus, molecular assay cycle thresholds, and analytical sensitivity. medRxiv. 2020 Aug 6;2020.08.05.20168963.
  41. L’Huillier AG, Torriani G, Pigny F, Kaiser L, Eckerle I. Culture-competent SARS-CoV-2 in nasopharynx of symptomatic neonates, children, and adolescents. Emerg Infect Dis. 2020;26(10):2494-7.  https://doi.org/10.3201/eid2610.202403  PMID: 32603290 
  42. Basile K, McPhie K, Carter I, Alderson S, Rahman H, Donovan L, et al. Cell-based culture of SARS-CoV-2 informs infectivity and safe de-isolation assessments during COVID-19. Clin Infect Dis. 2020;ciaa1579.
  43. Jeong HW, Kim SM, Kim HS, Kim YI, Kim JH, Cho JY, et al. Viable SARS-CoV-2 in various specimens from COVID-19 patients. Clin Microbiol Infect. 2020;26(11):1520-4.  https://doi.org/10.1016/j.cmi.2020.07.020  PMID: 32711057 
  44. Ladhani SN, Chow JY, Janarthanan R, Fok J, Crawley-Boevey E, Vusirikala A, et al. Investigation of SARS-CoV-2 outbreaks in six care homes in London, April 2020. EClinicalMedicine. 2020;26:100533.  https://doi.org/10.1016/j.eclinm.2020.100533  PMID: 32923993 
  45. Centers for Disease Control and Prevention (CDC). Interim guidance on duration of isolation and precautions for adults with COVID-19. Atlanta: CDC. [Accessed: 17 Mar 2021]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html
  46. Folgueira MD, Luczkowiak J, Lasala F, Perez-Rivilla A, Delgado R. Persistent SARS-CoV-2 replication in severe COVID-19. medRxiv. 2020 Jun 12;2020.06.10.20127837.
  47. Cheng HY, Jian SW, Liu DP, Ng TC, Huang WT, Lin HH, et al. Contact tracing assessment of COVID-19 transmission dynamics in Taiwan and risk at different exposure periods before and after symptom onset. JAMA Intern Med. 2020;180(9):1156-63.  https://doi.org/10.1001/jamainternmed.2020.2020  PMID: 32356867 
  48. Tu Y, Wei Y, Zhang D, Chen C, Hu X, Fei G. Analysis of factors affected the SARS-CoV-2 viral shedding time of COVID-19 patients in Anhui, China: a retrospective study. Research Square. 2020 Apr 6; https://doi.org/10.21203/rs.3.rs-20954/v1 .
  49. Iwasaki S, Fujisawa S, Nakakubo S, Kamada K, Yamashita Y, Fukumoto T, et al. Comparison of SARS-CoV-2 detection in nasopharyngeal swab and saliva. J Infect. 2020;81(2):e145-7.  https://doi.org/10.1016/j.jinf.2020.05.071  PMID: 32504740 
  50. Peng L, Liu J, Xu W, Luo Q, Deng K, Lin B, Gao Z. 2019 Novel Coronavirus can be detected in urine, blood, anal swabs and oropharyngeal swabs samples. medRxiv. 2020 Feb 25;2020.02.21.20026179
  51. Lee NY, Li CW, Tsai HP, Chen PL, Syue LS, Li MC, et al. A case of COVID-19 and pneumonia returning from Macau in Taiwan: Clinical course and anti-SARS-CoV-2 IgG dynamic. J Microbiol Immunol Infect. 2020;53(3):485-7.  https://doi.org/10.1016/j.jmii.2020.03.003  PMID: 32198005 
  52. Wang Y, Liu C, Meng Q, Gui S, Wu Y, Cheng P, et al. A case report of moderate COVID-19 with an extremely long-term viral shedding period in China. Research Square. 2020 Aug 19; https://doi.org/10.21203/rs.3.rs-59700/v1 
  53. Jiehao C, Jin X, Daojiong L, Zhi Y, Lei X, Zhenghai Q, et al. A case series of children with 2019 Novel Coronavirus infection: clinical and epidemiological features. Clin Infect Dis. 2020;71(6):1547-51.  https://doi.org/10.1093/cid/ciaa198  PMID: 32112072 
  54. Wu P, Liang L, Chen C, Nie S. A child confirmed COVID-19 with only symptoms of conjunctivitis and eyelid dermatitis. Graefes Arch Clin Exp Ophthalmol. 2020;258(7):1565-6.  https://doi.org/10.1007/s00417-020-04708-6  PMID: 32333104 
  55. Mao LJ, Xu J, Xu ZH, Xia XP, Li B, He JG, et al. A child with household transmitted COVID-19. BMC Infect Dis. 2020;20(1):329.  https://doi.org/10.1186/s12879-020-05056-w  PMID: 32381073 
  56. Sanville B, Corbett R, Pidcock W, Hardin K, Sebat C, Nguyen MV, et al. A community-transmitted case of severe acute respiratory distress syndrome (SARS) due to SARS-CoV-2 in the United States. Clin Infect Dis. 2020;71(16):2222-6.  https://doi.org/10.1093/cid/ciaa347  PMID: 32227197 
  57. Xu H, Liu E, Xie J, Smyth RL, Zhou Q, Zhao R, et al. A follow-up study of children infected with SARS-CoV-2 from western China. Ann Transl Med. 2020;8(10):623.  https://doi.org/10.21037/atm-20-3192  PMID: 32566560 
  58. Zheng Z, Dong M, Hu K. A preliminary evaluation on the efficacy of ozone therapy in the treatment of COVID-19. J Med Virol. 2020;92(11):2348-50.  https://doi.org/10.1002/jmv.26040  PMID: 32437014 
  59. Hu Y, Shen L, Yao Y, Xu Z, Zhou J, Zhou H. A report of three COVID-19 cases with prolonged viral RNA detection in anal swabs. Clin Microbiol Infect. 2020;26(6):786-7.  https://doi.org/10.1016/j.cmi.2020.04.010  PMID: 32304746 
  60. Liu Y, Chen X, Zou X, Luo H. A severe-type COVID-19 case with prolonged virus shedding. J Formos Med Assoc. 2020;119(10):1555-7.  https://doi.org/10.1016/j.jfma.2020.05.004  PMID: 32414666 
  61. Tan L, Kang X, Zhang B, Zheng S, Liu B, Tu T, et al. A special case of COVID-19 with long duration of viral shedding for 49 days. medRxiv. 2020 Mar 27;2020.03.22.20040071
  62. Qiu L, Jiao R, Zhang A, Chen X, Ning Q, Fang F, et al. A case of critically ill infant of coronavirus disease 2019 with persistent reduction of T Lymphocytes. Pediatr Infect Dis J. 2020;39(7):e87-90.  https://doi.org/10.1097/INF.0000000000002720  PMID: 32379199 
  63. Kam KQ, Yung CF, Cui L, Tzer Pin Lin R, Mak TM, Maiwald M, et al. A well infant with coronavirus disease 2019 with high viral load. Clin Infect Dis. 2020;71(15):847-9.  https://doi.org/10.1093/cid/ciaa201  PMID: 32112082 
  64. Fan Q, Pan Y, Wu Q, Liu S, Song X, Xie Z, et al. Anal swab findings in an infant with COVID-19. Pediatr Investig. 2020;4(1):48-50.  https://doi.org/10.1002/ped4.12186  PMID: 32328338 
  65. Seah IYJ, Anderson DE, Kang AEZ, Wang L, Rao P, Young BE, et al. Assessing viral shedding and infectivity of tears in Coronavirus Disease 2019 (COVID-19) patients. Ophthalmology. 2020;127(7):977-9.  https://doi.org/10.1016/j.ophtha.2020.03.026  PMID: 32291098 
  66. Chen X, Zhang Y, Zhu B, Zeng J, Hong W, He X, et al. Associations of clinical characteristics and antiviral drugs with viral RNA clearance in patients with COVID-19 in Guangzhou, China: a retrospective cohort study. medRxiv. 2020 Apr 14;2020.04.09.20058941
  67. Li C, Ji F, Wang L, Wang L, Hao J, Dai M, et al. Asymptomatic and human-to-human transmission of SARS-CoV-2 in a 2-family cluster, Xuzhou, China. Emerg Infect Dis. 2020;26(7):1626-8.  https://doi.org/10.3201/eid2607.200718  PMID: 32228809 
  68. Jiang X, Luo M, Zou Z, Wang X, Chen C, Qiu J. Asymptomatic SARS-CoV-2 infected case with viral detection positive in stool but negative in nasopharyngeal samples lasts for 42 days. J Med Virol. 2020;92(10):1807-9.  https://doi.org/10.1002/jmv.25941  PMID: 32330309 
  69. Thevarajan I, Nguyen THO, Koutsakos M, Druce J, Caly L, van de Sandt CE, et al. Breadth of concomitant immune responses prior to patient recovery: a case report of non-severe COVID-19. Nat Med. 2020;26(4):453-5.  https://doi.org/10.1038/s41591-020-0819-2  PMID: 32284614 
  70. Lim J, Jeon S, Shin HY, Kim MJ, Seong YM, Lee WJ, et al. Case of the index patient who caused tertiary transmission of COVID-19 infection in Korea: the application of Lopinavir/Ritonavir for the treatment of COVID-19 infected pneumonia monitored by quantitative RT-PCR. J Korean Med Sci. 2020;35(6):e79.  https://doi.org/10.3346/jkms.2020.35.e79  PMID: 32056407 
  71. Lombardi A, Consonni D, Carugno M, Bozzi G, Mangioni D, Muscatello A, et al. Characteristics of 1573 healthcare workers who underwent nasopharyngeal swab testing for SARS-CoV-2 in Milan, Lombardy, Italy. Clin Microbiol Infect. 2020;26(10):1413.e9-13.  https://doi.org/10.1016/j.cmi.2020.06.013  PMID: 32569835 
  72. Xu Y, Li X, Zhu B, Liang H, Fang C, Gong Y, et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med. 2020;26(4):502-5.  https://doi.org/10.1038/s41591-020-0817-4  PMID: 32284613 
  73. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020;20(6):689-96.  https://doi.org/10.1016/S1473-3099(20)30198-5  PMID: 32220650 
  74. Wolf GK, Glueck T, Huebner J, Muenchhoff M, Hoffmann D, French LE, et al. Clinical and epidemiological features of a family cluster of symptomatic and asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 infection. J Pediatric Infect Dis Soc. 2020;9(3):362-5.  https://doi.org/10.1093/jpids/piaa060  PMID: 32441753 
  75. Song R, Han B, Song M, Wang L, Conlon CP, Dong T, et al. Clinical and epidemiological features of COVID-19 family clusters in Beijing, China. J Infect. 2020;81(2):e26-30.  https://doi.org/10.1016/j.jinf.2020.04.018  PMID: 32335171 
  76. Chen M, Fan P, Liu Z, Li J, Huang S, Wu, et al. Clinical characteristics of 10 children with COVID-19 outside of Wuhan in Hubei Province. Research Square. 2020 Nov 21; https://doi.org/10.21203/rs.3.rs-18255/v1 
  77. Hu Z, Song C, Xu C, Jin G, Chen Y, Xu X, et al. Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Sci China Life Sci. 2020;63(5):706-11.  https://doi.org/10.1007/s11427-020-1661-4  PMID: 32146694 
  78. Pongpirul WA, Mott JA, Woodring JV, Uyeki TM, MacArthur JR, Vachiraphan A, et al. Clinical characteristics of patients hospitalized with Coronavirus Disease, Thailand. Emerg Infect Dis. 2020;26(7):1580-5.  https://doi.org/10.3201/eid2607.200598  PMID: 32267826 
  79. An J, Liao X, Xiao T, Qian S, Yuan J, Ye H, et al. Clinical characteristics of the recovered COVID-19 patients with re-detectable positive RNA test. medRxiv. 2020 Mar 30;2020.03.26.20044222
  80. Kim ES, Chin BS, Kang CK, Kim NJ, Kang YM, Choi JP, et al. Clinical Course and Outcomes of Patients with Severe Acute Respiratory Syndrome Coronavirus 2 Infection: a Preliminary Report of the First 28 Patients from the Korean Cohort Study on COVID-19. J Korean Med Sci. 2020;35(13):e142.  https://doi.org/10.3346/jkms.2020.35.e142  PMID: 32242348 
  81. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, 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(10229):1054-62.  https://doi.org/10.1016/S0140-6736(20)30566-3  PMID: 32171076 
  82. Xu T, Chen C, Zhu Z, Cui M, Chen C, Dai H, et al. Clinical features and dynamics of viral load in imported and non-imported patients with COVID-19. Int J Infect Dis. 2020;94:68-71.  https://doi.org/10.1016/j.ijid.2020.03.022  PMID: 32179140 
  83. Chen J, Qi T, Liu L, Ling Y, Qian Z, Li T, et al. Clinical progression of patients with COVID-19 in Shanghai, China. J Infect. 2020;80(5):e1-6.  https://doi.org/10.1016/j.jinf.2020.03.004  PMID: 32171869 
  84. Danis K, Epaulard O, Bénet T, Gaymard A, Campoy S, Botelho-Nevers E, et al. Cluster of Coronavirus Disease 2019 (COVID-19) in the French Alps, February 2020. Clin Infect Dis. 2020;71(15):825-32.  https://doi.org/10.1093/cid/ciaa424  PMID: 32277759 
  85. Fang Z, Zhang Y, Hang C, Ai J, Li S, Zhang W. Comparisons of viral shedding time of SARS-CoV-2 of different samples in ICU and non-ICU patients. J Infect. 2020;81(1):147-78.  https://doi.org/10.1016/j.jinf.2020.03.013  PMID: 32209381 
  86. To KK, Tsang OT, Yip CC, Chan KH, Wu TC, Chan JM, et al. Consistent Detection of 2019 Novel Coronavirus in Saliva. Clin Infect Dis. 2020;71(15):841-3.  https://doi.org/10.1093/cid/ciaa149  PMID: 32047895 
  87. Mandić-Rajčević S, Masci F, Crespi E, Franchetti S, Longo A, Bollina I, et al. Contact tracing and isolation of asymptomatic spreaders to successfully control the COVID-19 epidemic among healthcare workers in Milan (Italy). medRxiv. 2020 May 08;2020.05.03.20082818
  88. Nicastri E, D’Abramo A, Faggioni G, De Santis R, Mariano A, Lepore L, et al. Coronavirus disease (COVID-19) in a paucisymptomatic patient: epidemiological and clinical challenge in settings with limited community transmission, Italy, February 2020. Euro Surveill. 2020;25(11):2000230.  https://doi.org/10.2807/1560-7917.ES.2020.25.11.2000230  PMID: 32209164 
  89. Qiancheng X, Jian S, Lingling P, Lei H, Xiaogan J, Weihua L, et al. Coronavirus disease 2019 in pregnancy. Int J Infect Dis. 2020;95:376-83.  https://doi.org/10.1016/j.ijid.2020.04.065  PMID: 32353549 
  90. Zhu L, Gong N, Liu B, Lu X, Chen D, Chen S, et al. Coronavirus Disease 2019 pneumonia in immunosuppressed renal transplant recipients: a summary of 10 confirmed cases in Wuhan, China. Eur Urol. 2020;77(6):748-54.  https://doi.org/10.1016/j.eururo.2020.03.039  PMID: 32317180 
  91. Liu Y, Liao W, Wan L, Xiang T, Zhang W. Correlation between relative nasopharyngeal virus RNA Load and lymphocyte count disease severity in patients with COVID-19. Viral Immunol. 2020;vim.2020.0062.  https://doi.org/10.1089/vim.2020.0062  PMID: 32297828 
  92. Zha L, Li S, Pan L, Tefsen B, Li Y, French N, et al. Corticosteroid treatment of patients with coronavirus disease 2019 (COVID-19). Med J Aust. 2020;212(9):416-20.  https://doi.org/10.5694/mja2.50577  PMID: 32266987 
  93. Arashiro T, Furukawa K, Nakamura A. COVID-19 in 2 persons with mild upper respiratory tract symptoms on a cruise ship, Japan. Emerg Infect Dis. 2020;26(6):1345-8.  https://doi.org/10.3201/eid2606.200452  PMID: 32118533 
  94. Cai Q, Huang D, Ou P, Yu H, Zhu Z, Xia Z, et al. COVID-19 in a designated infectious diseases hospital outside Hubei Province, China. Allergy. 2020;75(7):1742-52.  https://doi.org/10.1111/all.14309  PMID: 32239761 
  95. Shastri A, Wheat J, Agrawal S, Chaterjee N, Pradhan K,Goldfinger M, et al. Delayed clearance of SARS-CoV2 in male compared to female patients: High ACE2 expression in testes suggests possible existence of gender-specific viral reservoirs. medRxiv. 2020 Apr 17;2020.04.16.20060566
  96. Marchand-Senécal X, Kozak R, Mubareka S, Salt N, Gubbay JB, Eshaghi A, et al. Diagnosis and management of first case of COVID-19 in Canada: lessons applied from SARS-CoV-1. Clin Infect Dis. 2020;71(16):2207-10.  https://doi.org/10.1093/cid/ciaa227  PMID: 32147731 
  97. Han C, Duan C, Zhang S, Spiegel B, Shi H, Wang W, et al. Digestive symptoms in COVID-19 patients with mild disease severity: clinical presentation, stool viral RNA resting, and outcomes. Am J Gastroenterol. 2020;115(6):916-23.  https://doi.org/10.14309/ajg.0000000000000664  PMID: 32301761 
  98. Wu F, Zhang W, Zhang L, Wang D, Wan Y. Discontinuation of antiviral drugs may be the reason for recovered COVID-19 patients testing positive again. Br J Hosp Med (Lond). 2020;81(4):1-2.  https://doi.org/10.12968/hmed.2020.0156  PMID: 32339007 
  99. Ma X, Su L, Zhang Y, Zhang X, Gai Z, Zhang Z. Do children need a longer time to shed SARS-CoV-2 in stool than adults? J Microbiol Immunol Infect. 2020;53(3):373-6.  https://doi.org/10.1016/j.jmii.2020.03.010  PMID: 32224116 
  100. Qian GQ, Chen XQ, Lv DF, Ma AHY, Wang LP, Yang NB, et al. Duration of SARS-CoV-2 viral shedding during COVID-19 infection. Infect Dis (Lond). 2020;52(7):511-2.  https://doi.org/10.1080/23744235.2020.1748705  PMID: 32275181 
  101. Tan LV, Ngoc NM, That BTT, Uyen LTT, Hong NTT, Dung NTP, et al. Duration of viral detection in throat and rectum of a patient with COVID-19. medRxiv. 2020 Mar 16;2020.03.07.20032052
  102. Lv DF, Ying QM, Weng YS, Shen CB, Chu JG, Kong JP, et al. Dynamic change process of target genes by RT-PCR testing of SARS-Cov-2 during the course of a Coronavirus Disease 2019 patient. Clin Chim Acta. 2020;506:172-5.  https://doi.org/10.1016/j.cca.2020.03.032  PMID: 32229107 
  103. Xiao AT, Tong YX, Gao C, Zhu L, Zhang YJ, Zhang S. Dynamic profile of RT-PCR findings from 301 COVID-19 patients in Wuhan, China: A descriptive study. J Clin Virol. 2020;127:104346.  https://doi.org/10.1016/j.jcv.2020.104346  PMID: 32361324 
  104. Lin A, He ZB, Zhang S, Zhang JG, Zhang X, Yan WH. Early risk factors for the duration of Severe Acute Respiratory Syndrome Coronavirus 2 viral positivity in patients with Coronavirus Disease 2019. Clin Infect Dis. 2020;71(16):2061-5.  https://doi.org/10.1093/cid/ciaa490  PMID: 32337591 
  105. Xiao T, Wang Y, Yuan J, Ye H, Wei L, Liao X, et al. Early viral clearance and antibody kinetics of COVID-19 among asymptomatic carriers. meRxiv. 2020 May 2;2020.04.28.20083139
  106. Zeng QL, Yu ZJ, Gou JJ, Li GM, Ma SH, Zhang GF, et al. Effect of convalescent plasma therapy on viral shedding and survival in patients with Coronavirus Disease 2019. J Infect Dis. 2020;222(1):38-43.  https://doi.org/10.1093/infdis/jiaa228  PMID: 32348485 
  107. Young BE, Ong SWX, Kalimuddin S, Low JG, Tan SY, Loh J, et al. Epidemiologic features and clinical course of patients infected With SARS-CoV-2 in Singapore. JAMA. 2020;323(15):1488-94.  https://doi.org/10.1001/jama.2020.3204  PMID: 32125362 
  108. Pan Y, Yu X, Du X, Li Q, Li X, Qin T, et al. Epidemiological and clinical characteristics of 26 asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 carriers. J Infect Dis. 2020;221(12):1940-7.  https://doi.org/10.1093/infdis/jiaa205  PMID: 32318703 
  109. Lo IL, Lio CF, Cheong HH, Lei CI, Cheong TH, Zhong X, et al. Evaluation of SARS-CoV-2 RNA shedding in clinical specimens and clinical characteristics of 10 patients with COVID-19 in Macau. Int J Biol Sci. 2020;16(10):1698-707.  https://doi.org/10.7150/ijbs.45357  PMID: 32226287 
  110. Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology. 2020;158(6):1831-1833.e3.  https://doi.org/10.1053/j.gastro.2020.02.055  PMID: 32142773 
  111. Cai Q, Yang M, Liu D, Chen J, Shu D, Xia J, et al. Experimental treatment with Favipiravir for COVID-19: an open-label control study. Engineering (Beijing). 2020;6(10):1192-8.  https://doi.org/10.1016/j.eng.2020.03.007  PMID: 32346491 
  112. Qi L, Yang Y, Jiang D, Tu C, Wan L, Chen X, et al. Factors associated with the duration of viral shedding in adults with COVID-19 outside of Wuhan, China: a retrospective cohort study. Int J Infect Dis. 2020;96:531-7.  https://doi.org/10.1016/j.ijid.2020.05.045  PMID: 32425636 
  113. Hu X, Xing Y, Jia J, Ni W, Liang J, Zhao D, et al. Factors associated with negative conversion of viral RNA in patients hospitalized with COVID-19. Sci Total Environ. 2020;728:138812.  https://doi.org/10.1016/j.scitotenv.2020.138812  PMID: 32335406 
  114. Xu K, Chen Y, Yuan J, Yi P, Ding C, Wu W, et al. Factors associated with prolonged viral RNA shedding in patients with Coronavirus Disease 2019 (COVID-19). Clin Infect Dis. 2020;71(15):799-806.  https://doi.org/10.1093/cid/ciaa351  PMID: 32271376 
  115. Yan D, Liu XY, Zhu YN, Huang L, Dan BT, Zhang GJ, et al. Factors associated with prolonged viral shedding and impact of lopinavir/ritonavir treatment in hospitalised non-critically ill patients with SARS-CoV-2 infection. Eur Respir J. 2020;56(1):2000799.  https://doi.org/10.1183/13993003.00799-2020  PMID: 32430428 
  116. Zhang J, Wang S, Xue Y. Fecal specimen diagnosis 2019 novel coronavirus-infected pneumonia. J Med Virol. 2020;92(6):680-2.  https://doi.org/10.1002/jmv.25742  PMID: 32124995 
  117. Mansour A, Atoui R, Kanso K, Mohsen R, Fares Y, Fares J. First Case of an Infant with COVID-19 in the Middle East. Cureus. 2020;12(4):e7520.  https://doi.org/10.7759/cureus.7520  PMID: 32377468 
  118. Cheng SC, Chang YC, Fan Chiang YL, Chien YC, Cheng M, Yang CH, et al. First case of Coronavirus Disease 2019 (COVID-19) pneumonia in Taiwan. J Formos Med Assoc. 2020;119(3):747-51.  https://doi.org/10.1016/j.jfma.2020.02.007  PMID: 32113824 
  119. Ghinai I, McPherson TD, Hunter JC, Kirking HL, Christiansen D, Joshi K, et al. First known person-to-person transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the USA. Lancet. 2020;395(10230):1137-44.  https://doi.org/10.1016/S0140-6736(20)30607-3  PMID: 32178768 
  120. Scott SE, Zabel K, Collins J, Hobbs KC, Kretschmer MJ, Lach M, et al. First mildly ill, nonhospitalized case of Coronavirus Disease 2019 (COVID-19) without viral transmission in the United States-Maricopa County, Arizona, 2020. Clin Infect Dis. 2020;71(15):807-12.  https://doi.org/10.1093/cid/ciaa374  PMID: 32240285 
  121. Wajnberg A, Mansour M, Leven E, Bouvier NM, Patel G, Firpo A, et al. Humoral immune response and prolonged PCR positivity in a cohort of 1343 SARS-CoV 2 patients in the New York City region. medRxiv. 2020 May 5;2020.04.30.20085613
  122. Gautret P, Lagier J-C, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020;56(1):105949.  https://doi.org/10.1016/j.ijantimicag.2020.105949  PMID: 32205204 
  123. Tang W, Cao Z, Han M, Wang Z, Chen J, Sun W, et al. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. BMJ. 2020;369:m1849.  https://doi.org/10.1136/bmj.m1849  PMID: 32409561 
  124. Mallat J, Hamed F, Balkis N, Mohamed MA, Mooty, M, Malik A. Hydroxychloroquine is associated with slower viral clearance in clinical COVID-19 patients with mild to moderate disease: A retrospective study. medRxiv. 2020 May 2;2020.04.27.20082180
  125. Chen X, Hu W, Ling J, Mo P, Zhang Y, Jiang Q, et al. Hypertension and diabetes delay the viral clearance in COVID-19 patients. medRxiv, 2020 Mar 24;2020.03.22.20040774
  126. Fu W, Chen Q, Wang T. Letter to the Editor: Three cases of redetectable positive SARS-CoV-2 RNA in recovered COVID-19 patients with antibodies. J Med Virol. 2020;92(11):2298-301.
  127. Huang J, Mao T, Li S, Wu L, Xu Z, Li H, et al. Long period dynamics of viral load and antibodies for SARS-CoV-2 infection: an observational cohort study. medRxiv. 2020 Apr 27;2020.04.22.20071258
  128. Lan X, Shao C, Zeng X, Wu Z, Xu Y. Lopinavir-ritonavir alone or combined with arbidol in the treatment of 73 hospitalized patients with COVID-19: a pilot retrospective study. medRxiv. 2020 Apr 29;2020.04.25.20079079
  129. Fang X, Mei Q, Yang T, Li L, Wang Y, Tong F, et al. Low-dose corticosteroid therapy does not delay viral clearance in patients with COVID-19. J Infect. 2020;81(1):147-78. PMID: 32283153 
  130. Shabrawishi MH, Naser AY, Alwafi H, Aldobyany AM, Touman AA. Negative nasopharyngeal SARS-CoV-2 PCR conversion in Response to different therapeutic interventions. medRxiv. 2020 May 11;2020.05.08.20095679
  131. Wang X, Zhou Q, He Y, Liu L, Ma X, Wei X, et al. Nosocomial outbreak of COVID-19 pneumonia in Wuhan, China. Eur Respir J. 2020;55(6):2000544.  https://doi.org/10.1183/13993003.00544-2020  PMID: 32366488 
  132. Chen L, Liu M, Zhang Z, Qiao K, Huang T, Chen M, et al. Ocular manifestations of a hospitalised patient with confirmed 2019 novel coronavirus disease. Br J Ophthalmol. 2020;104(6):748-51.  https://doi.org/10.1136/bjophthalmol-2020-316304  PMID: 32265202 
  133. Liu F, Xu A, Zhang Y, Xuan W, Yan T, Pan K, et al. Patients of COVID-19 may benefit from sustained Lopinavir-combined regimen and the increase of Eosinophil may predict the outcome of COVID-19 progression. Int J Infect Dis. 2020;95:183-91.  https://doi.org/10.1016/j.ijid.2020.03.013  PMID: 32173576 
  134. Yang R, Gui X, Xiong Y. Patients with respiratory symptoms are at greater risk of COVID-19 transmission. Respir Med. 2020;165:105935.  https://doi.org/10.1016/j.rmed.2020.105935  PMID: 32308203 
  135. Ling Y, Xu SB, Lin YX, Tian D, Zhu ZQ, Dai FH, et al. Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients. Chin Med J (Engl). 2020;133(9):1039-43.  https://doi.org/10.1097/CM9.0000000000000774  PMID: 32118639 
  136. Zhang B, Liu S, Dong Y, Zhang L, Zhong Q, Zou Y, et al. Positive rectal swabs in young patients recovered from coronavirus disease 2019 (COVID-19). J Infect. 2020;81(2):e49-52.  https://doi.org/10.1016/j.jinf.2020.04.023  PMID: 32335176 
  137. Qu YM, Kang EM, Cong HY. Positive result of Sars-Cov-2 in sputum from a cured patient with COVID-19. Travel Med Infect Dis. 2020;34:101619.  https://doi.org/10.1016/j.tmaid.2020.101619  PMID: 32160971 
  138. Luo A. Positive SARS-Cov-2 test in a woman with COVID-19 at 22 days after hospital discharge: A case report. Journal of Traditional Chinese Medical Sciences.2020;7(4):413-7.  https://doi.org/10.1016/j.jtcms.2020.04.001 
  139. Xing Y, Mo P, Xiao Y, Zhao O, Zhang Y, Wang F. Post-discharge surveillance and positive virus detection in two medical staff recovered from coronavirus disease 2019 (COVID-19), China, January to February 2020. Euro Surveill. 2020;25(10):2000191.  https://doi.org/10.2807/1560-7917.ES.2020.25.10.2000191  PMID: 32183934 
  140. 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(16):2249-51.  https://doi.org/10.1093/cid/ciaa460  PMID: 32306036 
  141. Wu Y, Guo C, Tang L, Hong Z, Zhou J, Dong X, et al. Prolonged presence of SARS-CoV-2 viral RNA in faecal samples. Lancet Gastroenterol Hepatol. 2020;5(5):434-5.  https://doi.org/10.1016/S2468-1253(20)30083-2  PMID: 32199469 
  142. Zhang WY, Yu LQ, Huang JA, Zeng DX. Prolonged Viral RNA Shedding Duration in COVID-19. Am J Ther. 2020;Publish Ahead of Print.  https://doi.org/10.1097/MJT.0000000000001200  PMID: 32366742 
  143. Xing YH, Ni W, Wu Q, Li WJ, Li GJ, Wang WD, et al. Prolonged viral shedding in feces of pediatric patients with coronavirus disease 2019. J Microbiol Immunol Infect. 2020;53(3):473-80.  https://doi.org/10.1016/j.jmii.2020.03.021  PMID: 32276848 
  144. Chen D, Xu W, Lei Z, Huang Z, Liu J, Gao Z, et al. Recurrence of positive SARS-CoV-2 RNA in COVID-19: A case report. Int J Infect Dis. 2020;93:297-9.  https://doi.org/10.1016/j.ijid.2020.03.003  PMID: 32147538 
  145. Wang H, Li Y, Wang F, Du H, Lu X. Rehospitalization of a Recovered Coronavirus Disease 19 (COVID-19) Child With Positive Nucleic Acid Detection. Pediatr Infect Dis J. 2020;39(6):e69-70.  https://doi.org/10.1097/INF.0000000000002690  PMID: 32282658 
  146. Chen X, Ling J, Mo P, Zhang Y, Jiang Q, Ma Z, et al. Restoration of leukomonocyte counts is associated with viral clearance in COVID-19 hospitalized patients. medRxiv. 2020 Mar 6;2020.03.03.20030437.
  147. Fu Y, Han P, Zhu R, Bai T, Yi J, Zhao X, et al. Risk factors for viral RNA shedding in COVID-19 patients. Eur Respir J. 2020;56(1):2001190.  https://doi.org/10.1183/13993003.01190-2020  PMID: 32398298 
  148. Colavita F, Lapa D, Carletti F, Lalle E, Bordi L, Marsella P, et al. SARS-CoV-2 isolation from ocular secretions of a patient with COVID-19 in Italy with prolonged viral RNA detection. Ann Intern Med. 2020;173(3):242-3.  https://doi.org/10.7326/M20-1176  PMID: 32302380 
  149. Zhang JF, Yan K, Ye HH, Lin J, Zheng JJ, Cai T. 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;97:212-4.  https://doi.org/10.1016/j.ijid.2020.03.007  PMID: 32200109 
  150. Huang Y, Chen S, Yang Z, Guan W, Liu D, Lin Z, et al. SARS-CoV-2 viral load in clinical samples from critically ill patients. Am J Respir Crit Care Med. 2020;201(11):1435-8.  https://doi.org/10.1164/rccm.202003-0572LE  PMID: 32293905 
  151. Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med. 2020;382(12):1177-9.  https://doi.org/10.1056/NEJMc2001737  PMID: 32074444 
  152. Han MS, Seong MW, Heo EY, Park JH, Kim N, Shin S, et al. Sequential analysis of viral load in a neonate and her mother infected with Severe Acute Respiratory Syndrome Coronavirus 2. Clin Infect Dis. 2020;71(16):2236-9.  https://doi.org/10.1093/cid/ciaa447  PMID: 32297925 
  153. Peng J, Wang M, Zhang G, Lu E. Seven discharged patients turning positive again for SARS-CoV-2 on quantitative RT-PCR. Am J Infect Control. 2020;48(6):725-6.  https://doi.org/10.1016/j.ajic.2020.03.017  PMID: 32317126 
  154. Le TQM, Takemura T, Moi ML, Nabeshima T, Nguyen LKH, Hoang VMP, et al. Severe Acute Respiratory Syndrome Coronavirus 2 Shedding by Travelers, Vietnam, 2020. Emerg Infect Dis. 2020;26(7):1624-6.  https://doi.org/10.3201/eid2607.200591  PMID: 32240079 
  155. Alshami AA, Alattas RA, Anan HF, Qahtani HSA, Mulhim MAA, Alahilmi AA, et al. Silent disease and loss of taste and smell are common manifestations of SARS-COV-2 infection in a quarantine facility: first report from Saudi Arabia. medRxiv. 2020 May 19;2020.05.13.20100222.
  156. Lu Y, Li Y, Deng W, Liu M, He Y, Huang L, et al. Symptomatic infection is associated with prolonged duration of viral shedding in mild Coronavirus Disease 2019: a retrospective study of 110 children in Wuhan. Pediatr Infect Dis J. 2020;39(7):e95-9.  https://doi.org/10.1097/INF.0000000000002729  PMID: 32379191 
  157. To KK, Tsang OT, Leung WS, Tam AR, Wu TC, Lung DC, et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis. 2020;20(5):565-74.  https://doi.org/10.1016/S1473-3099(20)30196-1  PMID: 32213337 
  158. Yuan J, Zou R, Zeng L, Kou S, Lan J, Li X, et al. The correlation between viral clearance and biochemical outcomes of 94 COVID-19 infected discharged patients. Inflamm Res. 2020;69(6):599-606.  https://doi.org/10.1007/s00011-020-01342-0  PMID: 32227274 
  159. Zhou B, She J, Wang Y, Ma X. Duration of viral shedding of discharged patients with severe COVID-19. Clin Infect Dis. 2020;71(16):2240-2.  https://doi.org/10.1093/cid/ciaa451  PMID: 32302000 
  160. Le HT, Nguyen LV, Tran DM, Do HT, Tran HT, Le YT, et al. The first infant case of COVID-19 acquired from a secondary transmission in Vietnam. Lancet Child Adolesc Health. 2020;4(5):405-6.  https://doi.org/10.1016/S2352-4642(20)30091-2  PMID: 32213326 
  161. Hill KJ, Russell CD, Clifford S, Templeton K, Mackintosh CL, Koch O, et al. The index case of SARS-CoV-2 in Scotland. J Infect. 2020;81(1):147-78.  https://doi.org/10.1016/j.jinf.2020.03.022  PMID: 32205138 
  162. Van Vinh Chau N, Lam VT, Dung NT, Yen LM, Minh NNQ, Hung LM, et al. The natural history and transmission potential of asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection. Clin Infect Dis. 2020;71(10):2679-87.  https://doi.org/10.1093/cid/ciaa711  PMID: 32497212 
  163. Chen Y, Chen L, Deng Q, Zhang G, Wu K, Ni L, et al. The presence of SARS-CoV-2 RNA in the feces of COVID-19 patients. J Med Virol. 2020;92(7):833-40.  https://doi.org/10.1002/jmv.25825  PMID: 32243607 
  164. Zhao F, Yang Y, Wang Z, Li L, Liu L, Liu Y. The time sequences of respiratory and rectal viral shedding in patients with Coronavirus Disease 2019. Gastroenterology. 2020;159(3):1158-1160.e2.  https://doi.org/10.1053/j.gastro.2020.05.035  PMID: 32425226 
  165. Chang D, Mo G, Yuan X, Tao Y, Peng X, Wang FS, et al. Time kinetics of viral clearance and resolution of symptoms in Novel Coronavirus infection. Am J Respir Crit Care Med. 2020;201(9):1150-2.  https://doi.org/10.1164/rccm.202003-0524LE  PMID: 32200654 
  166. Su JW, Wu WR, Lang GJ, Zhao H, Sheng JF. Transmission risk of patients with COVID-19 meeting discharge criteria should be interpreted with caution. J Zhejiang Univ Sci B. 2020;21(5):408-10.  https://doi.org/10.1631/jzus.B2000117  PMID: 32425008 
  167. Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J, et al. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. JAMA. 2020;323(16):1582-9.  https://doi.org/10.1001/jama.2020.4783  PMID: 32219428 
  168. Kim MS, Jang S-W, Park Y-K, Kim B, Hwang T-H, Kang SH, et al. Treatment response to Hydroxychloroquine, Lopinavir/Ritonavir, and antibiotics for moderate COVID 19: a first report on the pharmacological outcomes from South Korea. medRxiv. 2020 May 18;2020.05.13.20094193.
  169. Hung IF, Lung KC, Tso EY, Liu R, Chung TW, Chu MY, et al. Triple combination of interferon beta-1b, lopinavir-ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial. Lancet. 2020;395(10238):1695-704.  https://doi.org/10.1016/S0140-6736(20)31042-4  PMID: 32401715 
  170. Zhou R, Li F, Chen F, Liu H, Zheng J, Lei C, et al. Viral dynamics in asymptomatic patients with COVID-19. Int J Infect Dis. 2020;96:288-90.  https://doi.org/10.1016/j.ijid.2020.05.030  PMID: 32437933 
  171. Liu Y, Yan LM, Wan L, Xiang TX, Le A, Liu JM, et al. Viral dynamics in mild and severe cases of COVID-19. Lancet Infect Dis. 2020;20(6):656-7.  https://doi.org/10.1016/S1473-3099(20)30232-2  PMID: 32199493 
  172. Lui G, Ling L, Lai CK, Tso EY, Fung KS, Chan V, et al. Viral dynamics of SARS-CoV-2 across a spectrum of disease severity in COVID-19. J Infect. 2020;81(2):318-56.  https://doi.org/10.1016/j.jinf.2020.04.014  PMID: 32315724 
  173. Tan W, Lu Y, Zhang J, Wang J, Dan Y, Tan Z, et al. Viral kinetics and antibody responses in patients with COVID-19. medRxiv. 2020 Mar 26;2020.03.24.20042382.
  174. Zheng S, Fan J, Yu F, Feng B, Lou B, Zou Q, et al. Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study. BMJ. 2020;369:m1443.  https://doi.org/10.1136/bmj.m1443  PMID: 32317267 
  175. Pan Y, Zhang D, Yang P, Poon LLM, Wang Q. Viral load of SARS-CoV-2 in clinical samples. Lancet Infect Dis. 2020;20(4):411-2.  https://doi.org/10.1016/S1473-3099(20)30113-4  PMID: 32105638 
  176. Yuan C, Zhu H, Yang Y, Cai X, Xiang F, Wu H, et al. Viral loads in throat and anal swabs in children infected with SARS-CoV-2. Emerg Microbes Infect. 2020;9(1):1233-7.  https://doi.org/10.1080/22221751.2020.1771219  PMID: 32419639 
  177. Zhang N, Gong Y, Meng F, Bi Y, Yang P, Wang F. Virus shedding patterns in nasopharyngeal and fecal specimens of COVID-19 patients. medRxiv. 2020 Mar 30;2020.03.28.20043059.

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