Evidence map›Paper›PMID 40317518›Full record

ArticleJournal of the American Geriatrics Society2025

Kinetics of SARS-CoV-2 Shedding in Nursing Home Residents and Staff.

Morgan J Katz, Majerle Reeves, Tiffany G Harris, Jazmin Duque, Scott K Fridkin, Paulina A Rebolledo, Jon P Furuno, Emily K Short, David H Canaday, Yasin Abul and 19 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Morgan J KatzDepartment of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.ORCID 0000-0002-9908-195X
Majerle ReevesDivision of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Tiffany G HarrisAbt Global, Rockville, Maryland, USA.
Jazmin DuqueAbt Global, Rockville, Maryland, USA.
Scott K FridkinDepartment of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.ORCID 0000-0003-4892-693X
Paulina A RebolledoDepartment of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.
Jon P FurunoDepartment of Pharmacy Practice, Oregon State University College of Pharmacy, Portland, Oregon, USA.ORCID 0000-0002-8853-5733
Emily K ShortDepartment of Pharmacy Practice, Oregon State University College of Pharmacy, Portland, Oregon, USA.
David H CanadayDivision of Infectious Disease, Case Western Reserve University and Cleveland VA, Cleveland, Ohio, USA.
Yasin AbulDivision of Geriatrics and Palliative Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Stefan GravensteinDivision of Geriatrics and Palliative Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Sara E CosgroveDepartment of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Lona ModyDivision of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Jennifer MeddingsDivision of General Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
David A NaceDivision of Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID 0000-0002-3742-6991
Steven HandlerDepartment of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Christopher J CrnichDivision of Infectious Diseases, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Jennifer MeeceMarshfield Clinic Research Institute, Marshfield, Wisconsin, USA.
Richard J WebbySt. Jude Children's Research Hospital, Department of Host-Microbe Interactions, Memphis, Tennessee, USA.
Tom P FabrizioSt. Jude Children's Research Hospital, Department of Host-Microbe Interactions, Memphis, Tennessee, USA.
Jennifer L HarcourtCoronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Jessica M HealyCoronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Marc LipsitchCenter for Forecasting and Outbreak Analytics, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Joseph D LutgringDivision of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0001-5723-8317
Prabasaj PaulCenter for Forecasting and Outbreak Analytics, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Casey M ZipfelCenter for Forecasting and Outbreak Analytics, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Alfonso C Hernandez-RomieuCoronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Sujan C ReddyDivision of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Rachel B SlaytonDivision of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Funding

CDC HHS 75D30121D12704Intramural CDC HHS CC999999
6 · The paper itself

Abstract

backgroundNursing homes (NHs) were disproportionately affected by the COVID-19 pandemic. However, little is known regarding the kinetics of SARS-CoV-2 shedding in NH residents and staff, which could inform treatment and infection prevention.

methodsWe enrolled NH residents and staff in eight US states from April to November 2023 and analyzed the kinetics of SARS-CoV-2 using serial antigen and molecular (RT-PCR) tests, whole genome sequencing, and viral culture (VC). Symptoms, vaccination, and treatment were collected via interviews and chart review. Viral load trajectories were modeled with gamma distribution functional forms. Antigen and VC test positivity over time were assessed using a Chi-squared test.

resultsOf the 587 enrolled participants, 86 tested positive and 73 underwent testing for ≥ 10 days; most residents (78%) and staff (87%) had ≥ 3 COVID-19 vaccine doses. The modeled SARS-CoV-2 proliferation period (period prior to reaching peak viral load) had ended for 48% (14/29) of residents and 56% (9/16) of staff when they took the initial RT-PCR test. Both antigen and VC showed higher positivity rates early in the course of disease (Days 0-5 vs. Days ≥ 6) (antigen: p < 0·001, VC: p < 0·001). VC positivity was 15% after Day 5 (14/96); two participants were VC positive after Day 10.

conclusionsPeak viral load occurs early in the disease, suggesting asymptomatic and presymptomatic transmission may be a significant driver of transmission. Only two participants had a positive VC after Day 10, supporting current isolation and return to work recommendations.

Indexed as

COVID-19Nursing HomesSARS-CoV-2Virus SheddingAgedAged, 80 and overCOVID-19 VaccinesFemaleHumansMaleMiddle AgedUnited StatesViral LoadCOVID-19 VaccinesCOVID‐19kineticsnursing homeSARS‐CoV‐2shedding

Identifiers

PMID40317518
PMCPMC12303745

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.