Abstract
Background: PCR testing of respiratory tract specimens detects
SARS-CoV-2 viral shedding. Previous studies show that viral RNA was
detected from 1-83 days after COVID-19 symptom onset. This study aimed
to estimate time to viral clearance (TVC) for COVID-19 cases from
March-June 2020 in Jamaica. Methods: Cross-sectional analysis
was conducted on national surveillance data. Viral clearance was defined
as time from first positive nasopharyngeal swab to the first of two
consecutive negative tests. Confirmed cases and clinical severity were
based on WHO definitions. Frequency distributions, median and
interquartile ranges (IQR) were computed. Kruskal Wallis, Mann-Whitney U
and log rank tests evaluated differences by age, sex, and clinical
severity. Kaplan Meier curves described TVC by characteristics. A
p-value <0.05 was considered statistically significant.
Results: The analysis included 431 cases. Median TVC (days) was
28.0 (IQR: 18.0). Viral clearance differed by age (p<0.05),
sex (p<0.0001) and clinical severity (p<0.05). For
clinical severity, mildly ill cases had longest TVC (median: 29.0 days,
95%CI: 27-31). Females had a longer TVC (median: 30.0, 95%CI: 28-31)
than males (median: 23.0, 95%CI: 20-26). TVC was greater in cases
<60 years (median: 28.0 days, 95%CI: 26-30) than those ≥60
years (median: 19.0 days, 95%CI: 12-27). Forty-five percent of cases
were from a workplace cluster. TVC for workplace cluster versus
non-workplace cluster cases was 33.0, (95%CI: 31-34) versus 20.0,
(95%CI: 18-22) days. Conclusion: Median TVC was 28 days and
was influenced by age, sex, clinical severity and time of testing.
Future studies may be useful to clarify these differences.