At what times during infection is SARS-CoV-2 detectable and no longer detectable using RT-PCR-based tests? A systematic review of individual participant data

Mallett, Sue; Allen, A. Joy; Graziadio, Sara; Taylor, Stuart A.; Sakai, Naomi S.; Green, Kile; Suklan, Jana; Hyde, Chris; Shinkins, Bethany; Zhelev, Zhivko; Peters, Jaime; Turner, Philip J.; Roberts, Nia W.; di Ruffano, Lavinia Ferrante; Wolff, Robert; Whiting, Penny; Winter, Amanda; Bhatnagar, Gauraang; Nicholson, Brian D.; Halligan, Steve

doi:10.1186/s12916-020-01810-8

Table 1 Study characteristics of study design

From: At what times during infection is SARS-CoV-2 detectable and no longer detectable using RT-PCR-based tests? A systematic review of individual participant data

Ref	Author year	Country	Location	Setting	Date recruited	No. of participants in study	No. of IPD participants	Study design	Inclusion criteria: reference test
[9]	Cai 2020a	China	Wenzhou	Community	18 December 2019–12 February 2020	35	34	Contact tracing, all patients visited a shopping mall (confirmed COVID-19 cases that had contact with each other)	Positive RT-PCR test
[16]	Chang 2020	China	PLA General Hospital, Beijing	Hospital	28 January 2020 to 9 February 2020	16	16	Confirmed COVID-19 patients released from the Treatment Center of PLA General Hospital	Positive RT-PCR test from throat swabs
[10]	Chen 2020a	China	Beijing Ditan Hospital, Capital Medical University	Hospital	20 January to 27 February	133	22	Retrospectively identified a convenience sample of patients admitted to hospital	At least 2 positive RT-PCR test pharyngeal swabs
[12]	Chen 2020b	China	Shanghai, Shanghai Public Health Clinical Center.	Public Health Clinical Center	20 January 2020 to 6 February 2020	249	248	Retrospective cohort of laboratory confirmed cases	Positive RT-PCR test according to WHO interim guidelines
[29]	He 2020	China	Guangzhou Eighth People’s Hospital, Guangzhou, China	Hospital	21 January 2020 to 14 February 2020	94	19	All admitted COVID confirmed cases admitted to hospital	At least one positive RT-PCR test throat sample
[24]	Hu 2020a	China	Qingdao, Shandong	Hospital	29 January 2020 to 12 March 2020	59	59	Retrospective cohort of confirmed hospital cases	Positive RT-PCR test
[30]	Hu 2020b	China	Second Hospital of Nanjing, China	Hospital	28 January 2020 to 9 February 2020	24	23	Initial asymptomatic patients	Positive RT-PCR test and/or positive CT
[28]	Cai 2020b	China	Shanghai, China	Hospital	19 January 2020 to 3 February 2020	10	10	10 children admitted to hospital	Positive RT-PCR test nasopharyngeal or throat swab
[31]	Kujawski 2020	USA	Multiple sites, USA	Community	20 January 2020 to 5 February 2020	12	12	First 12 patients confirmed SARS-CoV-2 positive in the USA	Positive RT-PCR test in ≥ 1 specimen from a patient. Confirmed by CDC
[39]	Lavezzo 2020	Italy	Padua, Veneto region, Italy	Community	21 February 2020 to 7 March 2020	2812	80	Epidemiological study of entire population of Vo’, Italy, during complete closure of population movement	Positive RT-PCR test on nasopharyngeal swab
[27]	Lescure 2020	France	Paris, Bordeaux	Hospital	24 January 2020 to 29 January 2020	5	5	First 5 patients in France, exposed to COVID-19 in Hubei Province, China, prior to travel to France	Positive RT-PCR test
[34]	Li 2020	China	Xuzhou	Community	13 January 2020 to 17 February 2020	7	7	Asymptomatic contact tracing	Positive RT-PCR test
[14]	Liu 2020a	China	Hospital of Nanchang University	Hospital	21 January 2020 to 4 February 2020	76	25	Patients admitted to the hospital	Positive RT-PCR test from nasal swabs
[32]	Liu 2020b	China	Xixi Hospital of Hangzhou	Hospital	22 January 2020 to 11 February 2020	10	10	Hospital admission	Two consecutive positive RT-PCR tests
[18]	Lo 2020	China	Centro Hospitalar Conde de Sao Januario, Macau SAR, China	Hospital	21 January 2020 to 16 February 2020	10	10	Retrospective study of first 10 COVID-confirmed patients in Macau	Positive RT-PCR test
[20]	Lu 2020	China	Nantong, Nantong Third Hospital	Hospital	23 January 2020 to 6 March 2020	36	35	Retrospective analysis of clinical patients with fever, coughing, or lung inflammation	Positive RT-PCR test
[19]	Song 2020	China	Wuhan No. 1 Hospital, Nanjing Medical University	Hospital	31 January to 14 March 2020	13	13	Confirmed by CT images	Positive RT-PCR test
[13]	To 2020	China (Hong Kong)	Public Health Lab services branch in Hong Kong	Public Health Lab	Not reported	12	12	12 patients who presented with fever and acute respiratory distress, or pneumonia, and travel to Wuhan 14 days before onset of symptoms	Positive RT-PCR test from nasopharyngeal or sputum sample
[17]	Wolfel 2020	Germany	Munich, Germany	Hospital	Not reported	9	9	Patients that acquired infections upon known close contact to an index case (part of a larger cluster of epidemiologically linked cases that occurred after 23 January 2020 in Munich, Germany)	Positive RT-PCR test from oro- or nasopharyngeal swab
[37]	Wu 2020	China	Zhuhai, Guangdong	Hospital	16 January 2020 to 15 March 2020	74	41	Retrospective study of hospitalised patients	Positive RT-PCR test in two sequential respiratory tract samples
[40]	Wyllie 2020	USA	New Haven, CT	Community (healthcare workers)	Not reported to 5 April 2020	98 (44 inpatients)	19	Study of inpatients (44) and healthcare workers (98)	Positive RT-PCR test by nasopharyngeal swab or saliva
[21]	Xia 2020	China	Zhejiang	Hospital	26 January 2020 to 9 February 2020	30	30	A prospective interventional case series study of confirmed novel coronavirus pneumonia (NCP) patients at hospital	Positive RT-PCR test
[23]	Xiao 2020	China	Tongji Hospital, Huazhong, Wuhan	Hospital	21 January 2020 to 12 February 2020	56	56	30 confirmed novel coronavirus pneumonia (NCP) patients were selected	Positive RT-PCR test
[33]	Xu 2020a	China	Changzhou	Hospital	23 January 2020 to 27 February 2020	51	48	Hospital admission including 12 family clusters	Confirmed COVID-19 by Chinese diagnosis and treatment guideline
[36]	Xu 2020b	China	Guangzhou, Guangzhou Women and Children’s Medical Center	Hospital but from community surveillance	22 January 2020 to 20 February 2020	10	10	“Highly suspected” children with contact with confirmed COVID-19 person, or member of infected family group who was placed in quarantine	Positive RT-PCR test from nasopharyngeal or rectal swabs
[11]	Yang 2020	China	Shenzhen Third People’s	Hospital	11 January and 3 February 2020	213	13	COVID-19 positive hospitalised patients	Positive RT-PCR test
[26]	Young 2020	Singapore	4 hospitals in Singapore	Hospital	23 January 2020 to 3 February 2020	18	18	Contact tracing. First hospitalised patients in Singapore	Positive RT-PCR test
[22]	Yuan 2020	China	Fifth Affiliated Hospital, Zhuhai, Guangdong Province, China	Hospital	Late January	6	6	Case series	Positive RT-PCR test
[25]	Zhang 2020a	China	Wuhan Pulmonary Hospital, CAS Key Laboratory of Special Pathogens	Hospital	Not reported	Unclear	16	Prospective cohort patients	Positive RT-PCR test from oral swab
[35]	Zhang 2020b	China	Guangdong	Hospital	30 January 2020 to 5 February 2020	7	7	Prior hospitalisation for COVID-19, discharged under quarantine and subsequently positive by RT-PCR again	Positive RT-PCR test
[38]	Zheng 2020	China	Zheijang, China	Hospital	19 January 2020 to 15 February 2020	96	96	Retrospective cohort of 96 consecutively confirmed hospital cases	Positive RT-PCR test
[15]	Zou 2020	China	Zhuhai, Guangdong	Community and hospital	7 January to 26 January 2020	18	17	2 family clusters of patients infected by SARS-CoV	Positive RT-PCR test. Assay from Chinese CDC

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