Determination of immune and non-immune SARS-CoV-2 individuals among a community based on serological test will help us to estimate epidemiological variables including case-fatality and attack rate and also to identify subjects who mounted a strong virus specific antibody response which can be then detected and applied to treat patients via plasma therapy. Therefore, it is important to understand the key features of serology testing including the pattern of seroconversion over time, the first day of detectable antibodies, differences between antibodies wax and wane and duration of antibody response among COVID-19 infection. In addition, the combination testing of PCR and antibody measurement might significantly enhance the opportunity to detect present and past infection. Moreover, individual serology testing may reveal unsuspected previous exposure which indirectly could indicate presence of the virus among a population.
Population based serology could make a clear vision of the virus spreading pattern and total attack rate along with the prevalence of serological conversion. According to unclear features of the new virus, determination of the viral shedding in different populations is essential to determine an effective standard protocol in recovered patients' discharge, , ].įurthermore, antibody measurement is a crucial key which provides essential data on infection tracking. In addition to social distancing and quarantining of confirmed cases and contacts, viral shedding duration determination will help reducing viral transmission. High fever at the time of admission also resulted in longer SARS-CoV-2 shedding.
A case report also showed that a COVID-19 infected case had viral shedding for 46 days who was suffering from chronic hepatitis B infection and diabetes mellitus. In a study on MERS-CoV, diabetes was found to be correlated with prolonged detection of MERS-CoV RNA. in a retrospective cohort study on 96 patients observed prolonged viral shedding in severe cases in comparison with mild cases. Some studies have demonstrated that prolonged viral shedding is correlated with severe presentation of the virus. Viral shedding prolongation is among the current COVID-19 challenges which has been uncharacterized after symptoms resolution. A high viral shedding rate has been found during the first week of symptoms with a peak on the fourth day. In the first two weeks of the infection phase, the virus could be detected mostly in sputum followed by nasal swabs, while throat swabs were assessed unreliable eight days after symptom onset. The viral detection by PCR, is dependent on the time post illness initiation. Therefore, a clear vision of the viable viral shedding duration is critically important to provide a unique guidance for transmission-based isolation precautions. According to the variable data which is emerging rapidly, inpatient and outpatient isolation span has been controversial. Awareness of SARS-CoV-2 transmission dynamics could have significant implications for hospitalization and infection prevention to control the disease. The emergence of COVID-19 has become a global health threat worldwide since the pandemic started in December, 2019. In addition, IgG profiling indicated that it is persistent in a majority of patients for nearly 6 months which has brought some hopes in vaccine efficacy and application.
According to this data, the median viral shedding prolongation was 34.16 days which indicates that 14 days isolation might not be enough for population. Moreover, IgG was present in 84% of patients after 150 days. Shiver and body pain were found in prolonged form of the infection and also patients who had gastrointestinal problems experienced longer viral shedding. The median viral shedding among studied population was obtained 34.16 (☑7.65) days which was not significantly associated with age, sex and underlying diseases. The patients were followed until negative PCR achieved. 113 patients were confirmed for COVID-19 infection. Real Time RT-PCR assay was applied to determine the virus presence and SARS-CoV-2 antibodies were evaluated using SARS-CoV-2 IgM and IgG kits. We studied 255 COVID-19 suspected individuals to assess the viral shedding duration and also the antibody development against SARS-CoV-2 among the cases. Despite the great effort to eradicate this infection, there are still some challenges including different viral presentation, temporal immunity in infected individuals and variable data of viral shedding. SARS-CoV-2 as a new global threat has affected global population for one year.
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