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Recovered but RT-PCR-Positive Individuals Unlikely to Transmit SARS-CoV-2

THURSDAY, April 22, 2021 -- Individuals who have clinically recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and continue to test positive for viral RNA after completing the recommended isolation period do not appear to be infectious to others, according to a study published online April 22 in JAMA Internal Medicine.

Christina D. Mack, Ph.D., M.S.P.H., from IQVIA in Durham, North Carolina, and colleagues present case characteristics among individuals who had clinically recovered from SAR-CoV-2 infection but continued to have positive test results after discontinuation of isolation precautions in a retrospective cohort study. Data were obtained from June 11, 2020, to Oct. 19, 2020, as part of the National Basketball Association (NBA) closed campus occupational health program, which required daily reverse-transcription polymerase chain reaction (RT-PCR) testing and ad hoc serological testing.

The researchers found that 1 percent of the 3,648 individuals who participated were persistent-positive cases, and most were younger than 30 years and male (67 and 94 percent, respectively). Thirty-three individuals had antibodies; following the index persistent-positive RT-PCR result, all remained asymptomatic. For persistent-positive RT-PCR test results, cycle threshold values were typically above the Roche cobas SARS-CoV-2 limit of detection. Cases were monitored for up to 100 days, with at least 1,480 person-days of direct exposure activity; no transmission events or secondary infections of SARS-CoV-2 were detected.

"As the pandemic progresses, and particularly if the number of reported reinfection cases increases, interpretation of subsequent positive SARS-CoV-2 RT-PCR test results in recovered individuals will become increasingly challenging," the authors write.

Several authors are employees of IQVIA, which is in a paid consultancy with the NBA. Several authors disclosed financial ties to the pharmaceutical, medical technology, and sports industries.

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