Abstract

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.

Keywords

Viral sheddingCoronavirus disease 2019 (COVID-19)Transmissibility (structural dynamics)Transmission (telecommunications)QuarantineSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Viral loadMedicine2019-20 coronavirus outbreakConfidence intervalVirologyDiseaseImmunologyVirusInternal medicineOutbreakPathologyInfectious disease (medical specialty)

Affiliated Institutions

Related Publications

Publication Info

Year
2020
Type
article
Volume
26
Issue
5
Pages
672-675
Citations
4569
Access
Closed

External Links

View on DOI.org

Social Impact

Altmetric
PlumX Metrics

Social media, news, blog, policy document mentions

Citation Metrics

4569
OpenAlex

Cite This

Xi He, Eric H. Y. Lau, Peng Wu et al. (2020). Temporal dynamics in viral shedding and transmissibility of COVID-19. Nature Medicine , 26 (5) , 672-675. https://doi.org/10.1038/s41591-020-0869-5

Identifiers

DOI
10.1038/s41591-020-0869-5