Should qualitative RT-PCR be used to determine release from isolation of COVID-19 patients?

Karl Krupp; Purnima Madhivanan; Carlos M Perez-Velez

doi:10.1016/j.jinf.2020.06.030

Should qualitative RT-PCR be used to determine release from isolation of COVID-19 patients?

J Infect. 2020 Sep;81(3):452-482. doi: 10.1016/j.jinf.2020.06.030. Epub 2020 Jun 18.

Authors

Karl Krupp¹, Purnima Madhivanan², Carlos M Perez-Velez³

Affiliations

¹ Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295N. Martin Ave.; Drachman Hall A206X; PO Box 245209, Tucson, AZ 85724, USA. Electronic address: KKrupp@arizona.edu.
² Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295N. Martin Ave.; Drachman Hall A206X; PO Box 245209, Tucson, AZ 85724, USA; Division of Infectious Diseases, College of Medicine, University of Arizona, Tucson, Arizona, USA. Electronic address: PMadhivanan@arizona.edu.
³ Division of Infectious Diseases, College of Medicine, University of Arizona, Tucson, Arizona, USA; Pima County Health Department, 3950 South Country Club Road, Suite 100, Tucson, Arizona 84714, USA. Electronic address: CMPerezVelez@gmail.com.

Abstract

•
COVID-19 patients may have persistently positive RT-PCRs for as many as 9 weeks.
•
Some are being required to continue in isolation until they have negative results.
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SARS-CoV-2 qualitative RT-PCR does not distinguish infectious from noninfectious.
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Quantitative RT-PCRs and immunoassays are better markers of infectivity period.
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Social isolation can have economic, physical, psychological, and social effects.

Keywords: Coronavirus disease 2019 (COVID-19); Infectivity; Patient Isolation; Polymerase chain reaction (PCR); Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); Social Isolation; Socioeconomic Impact; Virus Shedding.

Publication types

Letter

MeSH terms

Betacoronavirus / isolation & purification*
COVID-19
COVID-19 Testing
Clinical Laboratory Techniques*
Coronavirus Infections / blood*
Coronavirus Infections / diagnosis
Coronavirus Infections / virology*
Humans
Pandemics
Patient Isolation / psychology*
Pneumonia, Viral / blood*
Pneumonia, Viral / virology*
Reverse Transcriptase Polymerase Chain Reaction*
SARS-CoV-2
Socioeconomic Factors
Virus Shedding