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Temporal dynamics in viral shedding and transmissibility of COVID-19.

Xi HeEric Ho Yin LauPeng WuXilong DengJian WangXinxin HaoYiu Chung LauJessica Y WongYujuan GuanXinghua TanXiaoneng MoYanqing ChenBaolin LiaoWeilie ChenFengyu HuQing ZhangMingqiu ZhongYanrong WuLingzhai ZhaoFuchun ZhangBenjamin John CowlingFang LiGabriel Matthew Leung
Published in: Nature medicine (2020)
We report temporal patterns of viral shedding in 94 patients with laboratory-confirmed COVID-19 and modeled COVID-19 infectiousness profiles from a separate sample of 77 infector-infectee transmission pairs. We observed the highest viral load in throat swabs at the time of symptom onset, and inferred that infectiousness peaked on or before symptom onset. We estimated that 44% (95% confidence interval, 25-69%) of secondary cases were infected during the index cases' presymptomatic stage, in settings with substantial household clustering, active case finding and quarantine outside the home. Disease control measures should be adjusted to account for probable substantial presymptomatic transmission.
Keyphrases
  • sars cov
  • coronavirus disease
  • respiratory syndrome coronavirus
  • healthcare