Temporal dynamics in viral shedding and transmissibility of COVID-19
Temporal dynamics in viral shedding and transmissibility of COVID-19
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DOI：
10.1038/s41591-020-0869-5
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发表时间：
2020-04-15
期刊：
影响因子：
82.9
通讯作者：
Leung, Gabriel M.
中科院分区：
文献类型：
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作者：
He, Xi;Lau, Eric H. Y.;Leung, Gabriel M.
我们报告了94例实验室确诊的COVID-19患者病毒脱落的时间模式，并从77对感染-感染传播对的单独样本中模拟了COVID-19的传染性特征。我们观察到在症状出现时咽拭子中病毒载量最高，并推断传染性在症状出现时或之前达到顶峰。我们估计44%（95%可信区间，25-69%）的继发性病例是在指示病例的症状前阶段，在大量家庭聚集、积极发现病例和在家外隔离的环境中感染的。应调整疾病控制措施，以考虑到可能出现的大量症状前传播。据估计，SARS-CoV-2的症状前传播占COVID-19病例的很大比例。
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.Presymptomatic transmission of SARS-CoV-2 is estimated to account for a substantial proportion of COVID-19 cases.