Long-term SARS-CoV-2 RNA shedding and its temporal association to IgG seropositivity

Vineet Agarwal, A. J. Venkatakrishnan, Arjun Puranik, Christian Kirkup, Agustin Lopez-Marquez, Douglas W. Challener, Elitza S. Theel, John C. O’Horo, Matthew J. Binnicker, Walter K. Kremers, William A. Faubion, Andrew D. Badley, Amy W. Williams, Gregory J. Gores, John D. Halamka, William G. Morice, Venky Soundararajan

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Longitudinal characterization of SARS-CoV-2 PCR testing from COVID-19 patient’s nasopharynx and its juxtaposition with blood-based IgG-seroconversion diagnostic assays is critical to understanding SARS-CoV-2 infection durations. Here, we retrospectively analyze 851 SARS-CoV-2-positive patients with at least two positive PCR tests and find that 99 of these patients remain SARS-CoV-2-positive after 4 weeks from their initial diagnosis date. For the 851-patient cohort, the mean lower bound of viral RNA shedding was 17.3 days (SD: 7.8), and the mean upper bound of viral RNA shedding from 668 patients transitioning to confirmed PCR-negative status was 22.7 days (SD: 11.8). Among 104 patients with an IgG test result, 90 patients were seropositive to date, with mean upper bound of time to seropositivity from initial diagnosis being 37.8 days (95% CI: 34.3–41.3). Our findings from juxtaposing IgG and PCR tests thus reveal that some SARS-CoV-2-positive patients are non-hospitalized and seropositive, yet actively shed viral RNA (14 of 90 patients). This study emphasizes the need for monitoring viral loads and neutralizing antibody titers in long-term non-hospitalized shedders as a means of characterizing the SARS-CoV-2 infection lifecycle.

Original languageEnglish (US)
Article number138
JournalCell Death Discovery
Issue number1
StatePublished - Dec 2020

ASJC Scopus subject areas

  • Immunology
  • Cellular and Molecular Neuroscience
  • Cell Biology
  • Cancer Research


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