• Kieran A Walsh, Susan Spillane, Laura Comber, Karen Cardwell, Patricia Harrington, Jeff Connell, Conor Teljeur, Natasha Broderick, Cillian F de Gascun, Susan M Smith, Máirín Ryan, and Michelle O'Neill.
• Health Information and Quality Authority, Smithfield, Dublin 7, Ireland. Electronic address: kiwalsh@hiqa.ie.
• J. Infect. 2020 Dec 1; 81 (6): 847-856.

ObjectivesTo summarise the evidence on the duration of infectiousness of individuals in whom SARS-CoV-2 ribonucleic acid is detected.MethodsA rapid review was undertaken in PubMed, Europe PubMed Central and EMBASE from 1 January 2020 to 26 August 2020.ResultsWe identified 15 relevant studies, including 13 virus culture and 2 contact tracing studies. For 5 virus culture studies, the last day on which SARS-CoV-2 was isolated occurred within 10 days of symptom onset. For another 5 studies, SARS-CoV-2 was isolated beyond day 10 for approximately 3% of included patients. The remaining 3 virus culture studies included patients with severe or critical disease; SARS-CoV-2 was isolated up to day 32 in one study. Two studies identified immunocompromised patients from whom SARS-CoV-2 was isolated for up to 20 days. Both contact tracing studies, when close contacts were first exposed greater than 5 days after symptom onset in the index case, found no evidence of laboratory-confirmed onward transmission of SARS-CoV-2.ConclusionCOVID-19 patients with mild-to-moderate illness are highly unlikely to be infectious beyond 10 days of symptoms. However, evidence from a limited number of studies indicates that patients with severe-to-critical illness or who are immunocompromised, may shed infectious virus for longer.Copyright © 2020. Published by Elsevier Ltd.

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