First 12 patients with coronavirus disease 2019 (COVID-19) in the United States

Stephanie A. Kujawski; Karen K Wong; Jennifer P. Collins; Lauren Epstein; Marie E. Killerby; Claire M. Midgley; Glen R. Abedi; N. Seema Ahmed; Olivia Almendares; Francisco N. Alvarez; Kayla N. Anderson; Sharon Balter; Vaughn Barry; Karri Bartlett; Karlyn Beer; Michael A. Ben-Aderet; Isaac Benowitz; Holly Biggs; Alison M. Binder; Stephanie R. Black; Brandon Bonin; Catherine M. Brown; Hollianne Bruce; Jonathan Bryant-Genevier; Alicia Budd; Diane Buell; Rachel Bystritsky; Jordan Cates; E. Matt Charles; Kevin Chatham-Stephens; Nora Chea; Howard Chiou; Demian Christiansen; Victoria Chu; Sara Cody; Max Cohen; Erin Conners; Aaron Curns; Vishal Dasari; Patrick Dawson; Traci DeSalvo; George Diaz; Matthew Donahue; Suzanne Donovan; Lindsey M. Duca; Keith Erickson; Mathew D. Esona; Suzanne Evans; Jeremy Falk; Leora R. Feldstein; Martin Fenstersheib; Marc Fischer; Rebecca Fisher; Chelsea Foo; Marielle J. Fricchione; Oren Friedman; Alicia M. Fry; Romeo R. Galang; Melissa M. Garcia; Susa I. Gerber; Graham Gerrard; Isaac Ghinai; Prabhu Gounder; Jonathan Grein; Cheri Grigg; Jeffrey D. Gunzenhauser; Gary I. Gutkin; Meredith Haddix; Aron J. Hall; George Han; Jennifer Harcourt; Kathleen Harriman; Thomas Haupt; Amber Haynes; Michelle Holshue; Cora Hoover; Jennifer C. Hunter; Max W. Jacobs; Claire Jarashow; Michael A. Jhung; Kiran Joshi; Talar Kamali; Shifaq Kamili; Lindsay Kim; Moon Kim; Jan King; Hannah L. Kirking; Amanda Kita-Yarbro; Rachel Klos; Miwako Kobayashi; Anna Kocharian; Kenneth K. Komatsu; Ram Koppaka; Jennifer E. Layden; Yan Li; Scott Lindquist; Stephen Lindstrom; Ruth Link-Gelles; Joana Lively; Michelle Livingston; Kelly Lo; Jennifer Lo; Xiaoyan Lu; Brian Lynch; Larry Madoff; Lakshmi Malapati; Gregory Marks; Mariel Marlow; Glenn E. Mathisen; Nancy McClung; Olivia McGovern; Tristan D. McPherson; Mitali Mehta; Audrey Meier; Lynn Mello; Sung-sil Moon; Margie Morgan; Ruth N. Moro; Janna' Murray; Rekha Murthy; Shannon Novosad; Sara E. Oliver; Jennifer O'Shea; Massimo Pacilli; Clinton R. Paden; Mark A. Pallansch; Manisha Patel; Sajan Patel; Isabel Pedraza; Satish K. Pillai; Talia Pindyck; Ian Pray; Krista Queen; Nichole Quick; Heather Reese; Brian Rha; Heather Rhodes; Susan Robinson; Philip Robinson; Melissa Rolfes; Janell Routh; Rachel Rubin; Sarah L. Rudman; Senthilkumar K. Sakthivel; Sarah Scott; Christopher Shepherd; Varun Shetty; Ethan A. Smith; Shanon Smith; Bryan Stierman; William Stoecker; Rebecca Sunenshine; Regina Sy-Santos; Azaibi Tamin; Ying Tao; Dawn Terashita; Natalie J. Thornburg; Suxiang Tong; Elizabeth Traub; Ahmet Tural; Anna Uehara; Timothy M. Uyeki; Grace Vahey; Jennifer R. Verani; Elsa Villarino; Megan Wallace; Lijuan Wang; John T. Watson; Matthew Westercamp; Brett Whitaker; Sarah Wilkerson; Rebecca C. Woodruff; Jonathan M. Wortham; Tiffany Wu; Amy Xie; Anna Yousaf; Matthew Zahn; Jing Zhang

Characterizing SARS-CoV-2 shedding is important to understand transmission and guide prevention strategies. We detected viral RNA and cultured virus from upper respiratory specimens, even from patients with lower respiratory tract illness. In general, Ct values in upper respiratory tract specimens were lowest during the first week of illness (suggesting high RNA counts), consistent with previous reports. 25-27 SARS-CoV-2 RNA was detected in respiratory tract specimens for 2-3 weeks in most patients and for up to 29 days as of February 22. In two patients with a productive cough, viral RNA was detected in sputum after RNA was no longer detectable in NP or OP specimens. SARS-CoV-2 RNA levels and duration of RNA detection did not appear to vary by illness severity, and several patients had viral RNA detected in respiratory specimens after reported symptom resolution.