Cited by 6,661SARS-CoV-2 and COVID-19 ResearchCOVID-19 Clinical Research StudiesSARS-CoV-2 detection and testing

The DOI matches its Crossref record; 34 of the 37 references it cites were found in a registry or an index.

Virological assessment of hospitalized patients with COVID-2019

Open access

Wölfel, Roman, Corman, Victor M., Guggemos, Wolfgang, Seilmaier, Michael, Zange, Sabine, Müller, Marcel A., Niemeyer, Daniela, Jones, Terry C., Vollmar, Patrick, Rothe, Camilla, Hoelscher, Michael, Bleicker, Tobias, Brünink, Sebastian, Schneider, Julia, Ehmann, Rosina, Zwirglmaier, Katrin, Drosten, Christian, Wendtner, Clemens·2020·Nature

DOI 10.1038/s41586-020-2196-x

Published version of a preprint

Open this paper in CoChat — free account Open PDF

Abstract

Coronavirus disease 2019 (COVID-19) is an acute infection of the respiratory tract that emerged in late 2019 1,2. Initial outbreaks in China involved 13.8% of cases with severe courses, and 6.1% of cases with critical courses 3. This severe presentation may result from the virus using a virus receptor that is expressed predominantly in the lung 2,4; the same receptor tropism is thought to have determined the pathogenicity-but also aided in the control-of severe acute respiratory syndrome (SARS) in 2003 5. However, there are reports of cases of COVID-19 in which the patient shows mild upper respiratory tract symptoms, which suggests the potential for pre- or oligosymptomatic transmission 6-8. There is an urgent need for information on virus replication, immunity and infectivity in specific sites of the body. Here we report a detailed virological analysis of nine cases of COVID-19 that provides proof of active virus replication in tissues of the upper respiratory tract. Pharyngeal virus shedding was very high during the first week of symptoms, with a peak at 7.11 × 10 8 RNA copies per throat swab on day 4. Infectious virus was readily isolated from samples derived from the throat or lung, but not from stool samples-in spite of high concentrations of virus RNA. Blood and urine samples never yielded virus. Active replication in the throat was confirmed by the presence of viral replicative RNA intermediates in the throat samples. We consistently detected sequence-distinct virus populations in throat and lung samples from one patient, proving independent replication. The shedding of viral RNA from sputum outlasted the end of symptoms. Seroconversion occurred after 7 days in 50% of patients (and by day 14 in all patients), but was not followed by a rapid decline in viral load. COVID-19 can present as a mild illness of the upper respiratory tract. The confirmation of active virus replication in the upper respiratory tract has implications for the containment of COVID-19.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1038/s41586-020-2196-x

Cites

34 of 34 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

A novel coronavirus from patients with pneumonia in China, 2019
Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., Zhao, X., Huang, B., Shi, W., Lu, R., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2001017 · Cited by 28,244
Epidemiological and clinical characteristics of 99 cases of 2019 novel Coronavirus pneumonia in Wuhan, China: a descriptive study.
Chen, N., Zhou, M., Dong, X., Qu, J., Gong, F., Han, Y., Qiu, Y., Wang, J., Liu, Y., Wei, Y., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30211-7 · Cited by 21,415
SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor
Hoffmann, M., Kleine-Weber, H., Schroeder, S., Krüger, N., Herrler, T., Erichsen, S., Schiergens, T. S., Herrler, G., Wu, N.-H., Nitsche, A., et al. (2020) · Cell · doi:10.1016/j.cell.2020.02.052 · Cited by 20,286
Self-citation
The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2
Gorbalenya, A. E., Baker, S. C., Baric, R. S., de Groot, R. J., Drosten, C., Gulyaeva, A. A., Haagmans, B. L., Lauber, C., Leontovich, A. M., Neuman, B. W., et al. (2020) · Nature Microbiology · doi:10.1038/s41564-020-0695-z · Cited by 8,745
Self-citation
Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR
Corman, V. M., Landt, O., Kaiser, M., Molenkamp, R., Meijer, A., Chu, D. K. W., Bleicker, T., Brünink, S., Schneider, J. A., Schmidt, M. L., et al. (2020) · Eurosurveillance · doi:10.2807/1560-7917.es.2020.25.3.2000045 · Cited by 7,266
Self-citation
First case of 2019 novel coronavirus in the United States
Holshue, M. L., DeBolt, C., Lindquist, S., Lofy, K. H., Wiesman, J., Bruce, H., Spitters, C., Ericson, K., Wilkerson, S., Tural, A., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2001191 · Cited by 6,030
SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients
Zou, L., Ruan, F., Huang, M.-X., Liang, L.-J., Huang, H., Hong, Z.-S., Yu, J.-X., Kang, M., Song, Y.-C., Xia, J., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmc2001737 · Cited by 4,590
Identification of a novel coronavirus in patients with severe acute respiratory syndrome
Drosten, C., Günther, S., Preiser, W., van der Werf, S., Brodt, H.-R., Becker, S., Rabenau, H., Panning, M., Kolesnikova, L., Fouchier, R. A. M., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa030747 · Cited by 4,574
Self-citation
A Novel Coronavirus Associated with Severe Acute Respiratory Syndrome
Tg, K., Erdman, D. D., Cs, G., Zaki, Peret, T. C. T., Emery, S. L., Tong, S., Urbani, C., Comer, J. A., Lim, W., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa030781 · Cited by 4,353
Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany
Rothe, C., Schunk, M., Sothmann, P., Bretzel, G., Froeschl, G., Wallrauch, C., Zimmer, T., Thiel, V., Jänke, C., Guggemos, W., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmc2001468 · Cited by 4,211
Self-citation

Show all 37 references

Sorted by citations

Items 101–200 of 1,012

US CDC Real-Time Reverse Transcription PCR Panel for Detection of Severe Acute Respiratory Syndrome Coronavirus 2
Lu, X., Wang, L., Sakthivel, S. K., Whitaker, B., Murray, J., Kamili, S., Lynch, B., Malapati, L., Burke, S. A., Harcourt, J. L., et al. (2020) · Emerging infectious diseases · doi:10.3201/eid2608.201246 · Cited by 689
Special considerations in the management of adult patients with acute leukaemias and myeloid neoplasms in the COVID-19 era: recommendations from a panel of international experts
Zeidan, A. M., Boddu, P. C., Patnaik, M. M., Bewersdorf, J. P., Stahl, M. F., Rampal, R. K., Shallis, R. M., Steensma, D. P., Savona, M. R., Sekeres, M. A., et al. (2020) · The Lancet Haematology · doi:10.1016/s2352-3026(20)30205-2 · Cited by 675
A colorimetric RT-LAMP assay and LAMP-sequencing for detecting SARS-CoV-2 RNA in clinical samples
Thi, V. L. D., Herbst, K., Börner, K., Meurer, M., Kremer, L. P. M., Kirrmaier, D., Freistaedter, A., Papagiannidis, D., Galmozzi, C. V., Stanifer, M. L., et al. (2020) · Science Translational Medicine · doi:10.1126/scitranslmed.abc7075 · Cited by 673
Immune determinants of COVID-19 disease presentation and severity
Brodin, P. (2021) · Nature Medicine · doi:10.1038/s41591-020-01202-8 · Cited by 670
Pathological sequelae of long-haul COVID
Mehandru, S., & Mérad, M. (2022) · Nature Immunology · doi:10.1038/s41590-021-01104-y · Cited by 675
Antibody tests for identification of current and past infection with SARS-CoV-2
Deeks, J. J., Dinnes, J., Takwoingi, Y., Davenport, C., Spijker, R., Taylor-Phillips, S., Adriano, A., Beese, S., Dretzke, J., di Ruffano, L. F., et al. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013652 · Cited by 649
Enhancement strategies for transdermal drug delivery systems: current trends and applications
Ramadon, D., McCrudden, M., Courtenay, A. J., & Donnelly, R. F. (2021) · Drug Delivery and Translational Research · doi:10.1007/s13346-021-00909-6 · Cited by 674
The prevalence of symptoms in 24,410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): A systematic review and meta-analysis of 148 studies from 9 countries
Grant, M. C., Geoghegan, L., Arbyn, M., Mohammed, Z., McGuinness, L. A., Clarke, E. L., & Wade, R. G. (2020) · PLoS ONE · doi:10.1371/journal.pone.0234765 · Cited by 676
Functional SARS-CoV-2-Specific Immune Memory Persists after Mild COVID-19
Rodda, L. B., Netland, J., Shehata, L., Pruner, K. B., Morawski, P. A., Thouvenel, C. D., Takehara, K. K., Eggenberger, J., Hemann, E. A., Waterman, H. R., et al. (2021) · Cell · doi:10.1016/j.cell.2020.11.029 · Cited by 647
Saliva is a reliable tool to detect SARS-CoV-2
Azzi, L., Carcano, G., Gianfagna, F., Grossi, P., Gasperina, D. D., Genoni, A. P., Fasano, M., Sessa, F., Tettamanti, L., Carinci, F., et al. (2020) · Journal of Infection · doi:10.1016/j.jinf.2020.04.005 · Cited by 643
What defines an efficacious COVID-19 vaccine? A review of the challenges assessing the clinical efficacy of vaccines against SARS-CoV-2
Hodgson, S. H., Mansatta, K., Mallett, G., Harris, V., Emary, K. R. W., & Pollard, A. J. (2021) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(20)30773-8 · Cited by 633
Single-cell landscape of immunological responses in patients with COVID-19
Zhang, J.-Y., Wang, X.-M., Xing, X., Xu, Z., Zhang, C., Song, J.-W., Fan, X., Xia, P., Fu, J.-L., Wang, S.-Y., et al. (2020) · Nature Immunology · doi:10.1038/s41590-020-0762-x · Cited by 642
Evaluation of lockdown effect on SARS-CoV-2 dynamics through viral genome quantification in waste water, Greater Paris, France, 5 March to 23 April 2020
Wurtzer, S., Maréchal, V., Mouchel, J., Maday, Y., Teyssou, R., Richard, E., Almayrac, J.-L., & Moulin, L. (2020) · Eurosurveillance · doi:10.2807/1560-7917.es.2020.25.50.2000776 · Cited by 632
“This suggests a possible enteric phase of the infection, although isolation of infectious virus from faeces seems difficult [7].”
BackgroundInfluential
SARS-CoV-2 detection, viral load and infectivity over the course of an infection
Walsh, K. A., Jordan, K., Clyne, B., Rohde, D., Drummond, L., Byrne, P., Ahern, S., Carty, P. G., O’Brien, K. K., Murchú, É. Ó., et al. (2020) · Journal of Infection · doi:10.1016/j.jinf.2020.06.067 · Cited by 603
The signal pathways and treatment of cytokine storm in COVID-19
Yang, L., Xie, X., Tu, Z., Fu, J., Xu, D., & Zhou, Y. (2021) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-021-00679-0 · Cited by 618
Immunity, endothelial injury and complement-induced coagulopathy in COVID-19
Perico, L., Benigni, A., Casiraghi, F., Ng, L. F. P., Rénia, L., & Remuzzi, G. (2020) · Nature Reviews Nephrology · doi:10.1038/s41581-020-00357-4 · Cited by 616
First environmental surveillance for the presence of SARS-CoV-2 RNA in wastewater and river water in Japan
Haramoto, E., Malla, B., Thakali, O., & Kitajima, M. (2020) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2020.140405 · Cited by 594
REGN-COV2 antibodies prevent and treat SARS-CoV-2 infection in rhesus macaques and hamsters
Baum, A., Ajithdoss, D., Copin, R., Zhou, A., Lanza, K., Negron, N., Ni, M., Wei, Y., Mohammadi, K., Musser, B., et al. (2020) · Science · doi:10.1126/science.abe2402 · Cited by 517
Viral infection and transmission in a large, well-traced outbreak caused by the SARS-CoV-2 Delta variant
Li, B., Deng, A., Li, K., Hu, Y., Li, Z., Shi, Y., Xiong, Q., Liu, Z., Guo, Q., Zou, L., et al. (2022) · Nature Communications · doi:10.1038/s41467-022-28089-y · Cited by 566
The cGAS–STING pathway drives type I IFN immunopathology in COVID-19
Domizio, J. D., Gulen, M. F., Saidoune, F., Thacker, V. V., Yatim, A., Sharma, K., Nass, T., Guenova, E., Schaller, M., Conrad, C., et al. (2022) · Nature · doi:10.1038/s41586-022-04421-w · Cited by 538
Candidate drugs against SARS-CoV-2 and COVID-19
McKee, D. L., Sternberg, A., Stange, U., Laufer, S., & Naujokat, C. (2020) · Pharmacological Research · doi:10.1016/j.phrs.2020.104859 · Cited by 572
Association of COVID-19 inflammation with activation of the C5a–C5aR1 axis
Carvelli, J., Demaria, O., Vély, F., Batista, L., Chouaki Benmansour, N., Fares, J., Carpentier, S., Thibult, M.-L., Morel, A., Remark, R., et al. (2020) · Nature · doi:10.1038/s41586-020-2600-6 · Cited by 526
SARS-CoV-2 infection triggers profibrotic macrophage responses and lung fibrosis
Wendisch, D., Dietrich, O., Mari, T., von Stillfried, S., Ibarra, I. L., Mittermaier, M., Mache, C., Chua, R. L., Knoll, R., Timm, S., et al. (2021) · Cell · doi:10.1016/j.cell.2021.11.033 · Cited by 528
“Respiratory failure and ARDS typically develop in the second week after symptom onset, in spite of declining viral loads (Barbaro et al., 2020; He et al., 2020; Jones et al., 2021; Wölfel et al., 2020).”
Self-citation
Computational analysis of SARS-CoV-2/COVID-19 surveillance by wastewater-based epidemiology locally and globally: Feasibility, economy, opportunities and challenges
Hart, O. E., & Halden, R. U. (2020) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2020.138875 · Cited by 557
Aerosol transmission of SARS-CoV-2? Evidence, prevention and control
Tang, S., Mao, Y., Jones, R. M., Tan, Q., Ji, J. S., Li, N., Shen, J., Lv, Y., Pan, L., Ding, P., et al. (2020) · Environment International · doi:10.1016/j.envint.2020.106039 · Cited by 552
Mapping Systemic Inflammation and Antibody Responses in Multisystem Inflammatory Syndrome in Children (MIS-C)
Gruber, C. N., Patel, R. S., Trachtman, R., Lepow, L., Amanat, F., Krammer, F., Wilson, K. M., Onel, K., Geanon, D., Tuballes, K., et al. (2020) · Cell · doi:10.1016/j.cell.2020.09.034 · Cited by 551
Diagnostic Performance of CT and Reverse Transcriptase Polymerase Chain Reaction for Coronavirus Disease 2019: A Meta-Analysis
Kim, H., Hong, H., & Yoon, S. H. (2020) · Radiology · doi:10.1148/radiol.2020201343 · Cited by 534
Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study
Hanley, B. P., Naresh, K. N., Roufosse, C. A., Nicholson, A. G., Weir, J., Cooke, G., Thursz, M. R., Manousou, P., Corbett, R., Goldin, R. D., et al. (2020) · The Lancet Microbe · doi:10.1016/s2666-5247(20)30115-4 · Cited by 540
Untuned antiviral immunity in COVID-19 revealed by temporal type I/III interferon patterns and flu comparison
Galani, I.-E., Rovina, N., Lampropoulou, V., Triantafyllia, V., Manioudaki, M., Pavlos, E., Koukaki, E., Fragkou, P. C., Panou, V., Rapti, V., et al. (2021) · Nature Immunology · doi:10.1038/s41590-020-00840-x · Cited by 503
Immunopathology of Hyperinflammation in COVID-19
Gustine, J. N., & Jones, D. (2021) · The American Journal of Pathology · doi:10.1016/j.ajpath.2020.08.009 · Cited by 516
Safety, tolerability and viral kinetics during SARS-CoV-2 human challenge in young adults
Killingley, B., Mann, A., Kalinova, M., Boyers, A., Goonawardane, N., Zhou, J., Lindsell, K., Hare, S. S., Brown, J. C., Frise, R., et al. (2022) · Nature Medicine · doi:10.1038/s41591-022-01780-9 · Cited by 532
Inflammasome activation in infected macrophages drives COVID-19 pathology
Sefik, E., Qu, R., Junqueira, C., Kaffe, E., Mirza, H., Zhao, J., Brewer, J. R., Han, A., Steach, H. R., Israelow, B., et al. (2022) · Nature · doi:10.1038/s41586-022-04802-1 · Cited by 543
Safety of foods, food supply chain and environment within the COVID-19 pandemic
Rizou, M., Galanakis, I. M., Aldawoud, T. M. S., & Galanakis, C. M. (2020) · Trends in Food Science & Technology · doi:10.1016/j.tifs.2020.06.008 · Cited by 536
The COVID-19 puzzle: deciphering pathophysiology and phenotypes of a new disease entity
Osuchowski, M. F., Winkler, M. S., Skirecki, T., Cajander, S., Shankar‐Hari, M., Lachmann, G., Monneret, G., Venet, F., Bauer, M. W., Brunkhorst, F. M., et al. (2021) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(21)00218-6 · Cited by 528
Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission
Rivett, L., Sridhar, S., Sparkes, D., Routledge, M., Jones, N. K., Forrest, S., Young, J., Pereira-Dias, J., Hamilton, W. L., Ferris, M., et al. (2020) · eLife · doi:10.7554/elife.58728 · Cited by 519
Remdesivir Inhibits SARS-CoV-2 in Human Lung Cells and Chimeric SARS-CoV Expressing the SARS-CoV-2 RNA Polymerase in Mice
Pruijssers, A. J. P., George, A. S., Schäfer, A., Leist, S. R., Gralinski, L. E., Dinnon, K. H., Yount, B. L., Agostini, M. L., Stevens, L. J., Chappell, J. D., et al. (2020) · Cell Reports · doi:10.1016/j.celrep.2020.107940 · Cited by 503
Airborne or Droplet Precautions for Health Workers Treating Coronavirus Disease 2019?
Bahl, P., Doolan, C. J., de Silva, C. M., Chughtai, A. A., Bourouiba, L., & MacIntyre, C. R. (2020) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiaa189 · Cited by 513
Serum IgA, IgM, and IgG responses in COVID-19
Ma, H., Zeng, W., He, H., Zhao, D., Yang, Y., Jiang, D., Qi, P. Y., He, W., Zhao, C., Yi, R., et al. (2020) · Cellular and Molecular Immunology · doi:10.1038/s41423-020-0474-z · Cited by 508
Evidence Supporting Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 While Presymptomatic or Asymptomatic
Furukawa, N. W., Brooks, J. T., & Sobel, J. (2020) · Emerging infectious diseases · doi:10.3201/eid2607.201595 · Cited by 505
Rapid reconstruction of SARS-CoV-2 using a synthetic genomics platform
Thao, T. T. N., Labroussaa, F., Ebert, N., V’kovski, P., Stalder, H., Portmann, J., Kelly, J. N., Steiner, S., Holwerda, M., Kratzel, A., et al. (2020) · Nature · doi:10.1038/s41586-020-2294-9 · Cited by 499
Self-citation
Organ-specific manifestations of COVID-19 infection
Gavriatopoulou, M., Korompoki, E., Fotiou, D., Ntanasis‐Stathopoulos, I., Ψαλτοπούλου, Θ., Kastritis, E., Terpos, E., & Dimopoulos, M. A. (2020) · Clinical and Experimental Medicine · doi:10.1007/s10238-020-00648-x · Cited by 501
COVID-19–related anosmia is associated with viral persistence and inflammation in human olfactory epithelium and brain infection in hamsters
de Melo, G. D., Lazarini, F., Levallois, S., Hautefort, C., Michel, V., Larrous, F., Vérillaud, B., Aparicio, C., Wagner, S., Gheusi, G., et al. (2021) · Science Translational Medicine · doi:10.1126/scitranslmed.abf8396 · Cited by 516
Pathophysiology of COVID-19-associated acute kidney injury
Legrand, M. M., Bell, S., Forni, L. G., Joannidis, M., Koyner, J. L., Liu, K. D., & Cantaluppi, V. (2021) · Nature Reviews Nephrology · doi:10.1038/s41581-021-00452-0 · Cited by 527
Modelling aerosol transport and virus exposure with numerical simulations in relation to SARS-CoV-2 transmission by inhalation indoors
Vuorinen, V., Aarnio, M., Alava, M., Alopaeus, V., Atanasova, N., Auvinen, M., Balasubramanian, N., Bordbar, H., Erästö, P., Grande, R., et al. (2020) · Safety Science · doi:10.1016/j.ssci.2020.104866 · Cited by 472
Household secondary attack rate of COVID-19 and associated determinants in Guangzhou, China: a retrospective cohort study
Jing, Q.-L., Liu, M.-J., Zhang, Z.-B., Fang, L.-Q., Yuan, J., Zhang, A.-R., Dean, N. E., Luo, L., Ma, M.-M., Longini, I. M., et al. (2020) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(20)30471-0 · Cited by 492
Rapid, Ultrasensitive, and Quantitative Detection of SARS-CoV-2 Using Antisense Oligonucleotides Directed Electrochemical Biosensor Chip
Alafeef, M., Dighe, K., Moitra, P., & Pan, D. (2020) · ACS Nano · doi:10.1021/acsnano.0c06392 · Cited by 498
Clinical Course and Molecular Viral Shedding Among Asymptomatic and Symptomatic Patients With SARS-CoV-2 Infection in a Community Treatment Center in the Republic of Korea
Lee, S., Kim, T., Lee, E. J., Lee, C., Kim, H., Rhee, H., Park, S. Y., Son, H., Yu, S., Park, J. W., et al. (2020) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2020.3862 · Cited by 486
Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: a cohort study in Beijing, China
Wang, Y., Tian, H., Zhang, L., Zhang, M., Guo, D., Wu, W., Zhang, X., Kan, G. L., Jia, L., Huo, D., et al. (2020) · BMJ Global Health · doi:10.1136/bmjgh-2020-002794 · Cited by 493
Diagnostics for COVID-19: moving from pandemic response to control
Peeling, R. W. W., Heymann, D. L., Teo, Y.-Y., & Garcia, P. J. (2021) · The Lancet · doi:10.1016/s0140-6736(21)02346-1 · Cited by 509
First detection of SARS-CoV-2 RNA in wastewater in North America: A study in Louisiana, USA
Sherchan, S. P., Shahin, S. A., Ward, L. M., Tandukar, S., Aw, T. G., Schmitz, B. W., Ahmed, W., & Kitajima, M. (2020) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2020.140621 · Cited by 481
Efficacy of masks and face coverings in controlling outward aerosol particle emission from expiratory activities
Asadi, S., Cappa, C. D., Barreda, S., Wexler, A. S., Bouvier, N. M., & Ristenpart, W. D. (2020) · Scientific Reports · doi:10.1038/s41598-020-72798-7 · Cited by 480
Impact of online information on self-isolation intention during the covid-19 pandemic: Cross-sectional study
Farooq, A., Laato, S., & Islam, A. K. M. N. (2020) · Journal of Medical Internet Research · doi:10.2196/19128 · Cited by 467
Overcoming the bottleneck to widespread testing: a rapid review of nucleic acid testing approaches for COVID-19 detection
Esbin, M. N., Whitney, O. N., Chong, S., Maurer, A. C., Darzacq, X., & Tjian, R. (2020) · RNA · doi:10.1261/rna.076232.120 · Cited by 477
A guideline to limit indoor airborne transmission of COVID-19
Bazant, M. Z., & Bush, J. W. M. (2021) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2018995118 · Cited by 493
Wastewater surveillance for population-wide Covid-19: The present and future
Daughton, C. G. (2020) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2020.139631 · Cited by 495
First proof of the capability of wastewater surveillance for COVID-19 in India through detection of genetic material of SARS-CoV-2
Kumar, M., Patel, A. K., Shah, A. V., Raval, J. N., Rajpara, N., Joshi, M. N., & Joshi, C. G. (2020) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2020.141326 · Cited by 475
Kinetics of SARS-CoV-2 specific IgM and IgG responses in COVID-19 patients
Sun, B., Feng, Y., Mo, X., Zheng, P., Wang, Q., Li, P., Peng, P., Liu, X., Chen, Z., Huang, H., et al. (2020) · Emerging Microbes & Infections · doi:10.1080/22221751.2020.1762515 · Cited by 479
Sensitivity in Detection of Antibodies to Nucleocapsid and Spike Proteins of Severe Acute Respiratory Syndrome Coronavirus 2 in Patients With Coronavirus Disease 2019
Burbelo, P. D., Riedo, F. X., Morishima, C., Rawlings, S. A., Smith, D. M., Das, S., Strich, J. R., Chertow, D. S., Davey, R. T., & Cohen, J. I. (2020) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiaa273 · Cited by 471
Quantitative assessment of the risk of airborne transmission of SARS-CoV-2 infection: prospective and retrospective applications
Buonanno, G., Morawska, L., & Stabile, L. (2020) · Environment International · doi:10.1016/j.envint.2020.106112 · Cited by 449
Evaluation of SARS-CoV-2 serology assays reveals a range of test performance
Whitman, J. D., Hiatt, J. B., Mowery, C. T., Shy, B. R., Yu, R., Yamamoto, T. N., Rathore, U., Goldgof, G. M., Whitty, C., Woo, J. M., et al. (2020) · Nature Biotechnology · doi:10.1038/s41587-020-0659-0 · Cited by 455
AGA Institute Rapid Review of the Gastrointestinal and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19
Sultan, S., Altayar, O., Siddique, S. M., Davitkov, P., Feuerstein, J. D., Lim, J. K., Falck-Ytter, Y., & El-Serag, H. B. (2020) · Gastroenterology · doi:10.1053/j.gastro.2020.05.001 · Cited by 437
Depicting SARS-CoV-2 faecal viral activity in association with gut microbiota composition in patients with COVID-19
Zuo, T., Liu, Q., Zhang, F., Lui, G. C.-Y., Tso, E. Y. K., Yeoh, Y. K., Chen, Z., Boon, S. S., Chan, F. K. L., Chan, P. K. S., et al. (2020) · Gut · doi:10.1136/gutjnl-2020-322294 · Cited by 457
Tracheostomy in the COVID-19 era: global and multidisciplinary guidance
McGrath, B. A., Brenner, M. J., Warrillow, S. J., Pandian, V., Arora, A., Cameron, T. S., Añón, J. M., Martínez, G. H., Truog, R. D., Block, S. D., et al. (2020) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(20)30230-7 · Cited by 458
The first 12 months of COVID-19: a timeline of immunological insights
Carvalho, T., Krammer, F., & Iwasaki, A. (2021) · Nature reviews. Immunology · doi:10.1038/s41577-021-00522-1 · Cited by 483
COVID-19 and multiorgan failure: A narrative review on potential mechanisms
Mokhtari, T., Hassani, F., Ghaffari, N., Ebrahimi, B., Yarahmadi, A., & Hassanzadeh, G. (2020) · Journal of Molecular Histology · doi:10.1007/s10735-020-09915-3 · Cited by 449
COVID-19: Discovery, diagnostics and drug development
Asselah, T., Durantel, D., Pasmant, É., Lau, G. K. K., & Schinazi, R. F. (2020) · Journal of Hepatology · doi:10.1016/j.jhep.2020.09.031 · Cited by 478
Chest CT in COVID-19: What the Radiologist Needs to Know
Kwee, T. C., & Kwee, R. M. (2020) · Radiographics · doi:10.1148/rg.2020200159 · Cited by 451
COVID-19 surveillance in Southeastern Virginia using wastewater-based epidemiology
González, R., Curtis, K., Bivins, A. W., Bibby, K. J., Weir, M. H., Yetka, K., Thompson, H. M., Keeling, D., Mitchell, J., & González, D. (2020) · Water Research · doi:10.1016/j.watres.2020.116296 · Cited by 443
Investigation of a COVID-19 outbreak in Germany resulting from a single travel-associated primary case: a case series
Böhmer, M. M., Buchholz, U., Corman, V. M., Hoch, M., Katz, K., Marosevic, D., Böhm, S., Woudenberg, T., Ackermann, N., Konrad, R., et al. (2020) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(20)30314-5 · Cited by 462
Self-citation
Evaluating the Effectiveness of Social Distancing Interventions to Delay or Flatten the Epidemic Curve of Coronavirus Disease
Matrajt, L., & Leung, T. (2020) · Emerging infectious diseases · doi:10.3201/eid2608.201093 · Cited by 445
Epidemiology and clinical features of COVID-19: A review of current literature
Siordia, J. A. (2020) · Journal of Clinical Virology · doi:10.1016/j.jcv.2020.104357 · Cited by 441
Wastewater-Based Epidemiology: Global Collaborative to Maximize Contributions in the Fight Against COVID-19
Bivins, A. W., North, D., Ahmad, A., Ahmed, W., Alm, E. J., Béen, F. M., Bhattacharya, P., Bijlsma, L., Boehm, A. B. B., Brown, J. M., et al. (2020) · Environmental Science & Technology · doi:10.1021/acs.est.0c02388 · Cited by 429
SARS-CoV-2 viral load and shedding kinetics
Puhach, O., Meyer, B., & Eckerle, I. (2022) · Nature Reviews Microbiology · doi:10.1038/s41579-022-00822-w · Cited by 462
Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil
de Souza, W. M., Buss, L., Cândido, D. D. S., Carrera, J., Li, S., Zarebski, A. E., Pereira, R. H. M., Junior, C. A. P., Santos, A. A. D. S., Parag, K. V., et al. (2020) · Nature Human Behaviour · doi:10.1038/s41562-020-0928-4 · Cited by 444
COVID-19: interim guidance on rehabilitation in the hospital and post-hospital phase from a European Respiratory Society- and American Thoracic Society-coordinated international task force
Spruit, M. A., Holland, A. E., Singh, S., Tonia, T., Wilson, K. C., & Troosters, T. (2020) · European Respiratory Journal · doi:10.1183/13993003.02197-2020 · Cited by 441
Gastrointestinal symptoms and fecal shedding of SARS-CoV-2 RNA suggest prolonged gastrointestinal infection
Natarajan, A., Zlitni, S., Brooks, E. F., Vance, S. E., Dahlen, A., Hedlin, H., Park, R. M., Han, A., Schmidtke, D. T., Verma, R., et al. (2022) · Med · doi:10.1016/j.medj.2022.04.001 · Cited by 420
“Five studies have reported isolating infectious SARS-CoV-2 from stool samples collected from participants with severe COVID-19, whereas others have reportedbeingunable to isolate infectious virions fromstool.(19,20) Therefore, it remains unclearwhether thepresenceof infectious virions of SARS-CoV-2 in the stool is a r…”
Cigarette Smoke Exposure and Inflammatory Signaling Increase the Expression of the SARS-CoV-2 Receptor ACE2 in the Respiratory Tract
Smith, J. C., Sausville, E. L., Girish, V., Yuan, M. L., Vasudevan, A., John, K. M., & Sheltzer, J. M. (2020) · Developmental Cell · doi:10.1016/j.devcel.2020.05.012 · Cited by 431
Effects of ventilation on the indoor spread of COVID-19
Bhagat, R. K., Wykes, M. S. D., Dalziel, S. B., & Linden, P. F. (2020) · Journal of Fluid Mechanics · doi:10.1017/jfm.2020.720 · Cited by 415
Assessment of Maternal and Neonatal SARS-CoV-2 Viral Load, Transplacental Antibody Transfer, and Placental Pathology in Pregnancies During the COVID-19 Pandemic
Edlow, A. G., Li, J. Z., Collier, A.-R. Y., Atyeo, C. G., James, K. E., Boatin, A. A., Gray, K. J., Bordt, E. A., Shook, L. L., Yonker, L. M., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.30455 · Cited by 403
Transmission heterogeneities, kinetics, and controllability of SARS-CoV-2
Sun, K., Wang, W., Gao, L., Wang, Y., Luo, K., Ren, L., Zhan, Z., Chen, X., Zhao, S., Huang, Y., et al. (2020) · Science · doi:10.1126/science.abe2424 · Cited by 417
Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers: A Randomized Controlled Trial
Bundgaard, H., Bundgaard, J. S., Raaschou-Pedersen, D. E. T., von Buchwald, C., Todsen, T., Norsk, J. B., Pries-Heje, M. M., Vissing, C. R., Nielsen, P. B., Winsløw, U. C., et al. (2021) · Annals of Internal Medicine · doi:10.7326/m20-6817 · Cited by 388
“This definition was chosen because the viral load of infected patients may be only transiently detectable (31, 32) and because approximately half of persons infected with SARS-CoV-2 are asymptomatic (26, 33).”
Background
Coughs and Sneezes: Their Role in Transmission of Respiratory Viral Infections, Including SARS-CoV-2
Dhand, R., & Li, J. (2020) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202004-1263pp · Cited by 428
SARS-CoV-2-mediated dysregulation of metabolism and autophagy uncovers host-targeting antivirals
Gassen, N. C., Papies, J., Bajaj, T., Emanuel, J., Dethloff, F., Chua, R. L., Trimpert, J., Heinemann, N., Niemeyer, C., Weege, F., et al. (2021) · Nature Communications · doi:10.1038/s41467-021-24007-w · Cited by 413
Self-citation
Mathematical modelling of COVID-19 transmission and mitigation strategies in the population of Ontario, Canada
Tuite, A. R., Fisman, D. N., & Greer, A. L. (2020) · Canadian Medical Association Journal · doi:10.1503/cmaj.200476 · Cited by 414
Clinical and virologic characteristics of the first 12 patients with coronavirus disease 2019 (COVID-19) in the United States
The COVID-19 Investigation Team (2020) · Nature Medicine · doi:10.1038/s41591-020-0877-5 · Cited by 401
Tools and Techniques for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)/COVID-19 Detection
Tali, S. H. S., LeBlanc, J. J., Sadiq, Z., Oyewunmi, O. D., Camargo, C., Nikpour, B., Armanfard, N., Sagan, S. M., & Jahanshahi‐Anbuhi, S. (2021) · Clinical Microbiology Reviews · doi:10.1128/cmr.00228-20 · Cited by 430
Type III interferons disrupt the lung epithelial barrier upon viral recognition
Broggi, A., Ghosh, S., Sposito, B., Spreafico, R., Balzarini, F., Cascio, A. L., Clementi, N., Santis, M. D., Mancini, N., Granucci, F., et al. (2020) · Science · doi:10.1126/science.abc3545 · Cited by 403
A Systematic Review of the Clinical Utility of Cycle Threshold Values in the Context of COVID-19
Rao, S. N., Manissero, D., Steele, V. R., & Pareja, J. (2020) · Infectious Diseases and Therapy · doi:10.1007/s40121-020-00324-3 · Cited by 399
Shedding of SARS-CoV-2 in feces and urine and its potential role in person-to-person transmission and the environment-based spread of COVID-19
Jones, D. L., Quintela‐Baluja, M., Graham, D. W., Corbishley, A., McDonald, J. E., Malham, S. K., Hillary, L. S., Connor, T. R., Gaze, W. H., Moura, I. B., et al. (2020) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2020.141364 · Cited by 404
COVID-19 diagnostics in context
Weissleder, R., Lee, H., Ko, J., & Pittet, M. J. (2020) · Science Translational Medicine · doi:10.1126/scitranslmed.abc1931 · Cited by 415
Immunological and inflammatory profiles in mild and severe cases of COVID-19
Song, J., Zhang, C., Fan, X., Meng, F.-P., Xu, Z., Xia, P., Cao, W.-J., Yang, T., Dai, X.-P., Wang, S., et al. (2020) · Nature Communications · doi:10.1038/s41467-020-17240-2 · Cited by 398
COVID-19 neuropathology at Columbia University Irving Medical Center/New York Presbyterian Hospital
Thakur, K. T., Miller, E. H., Glendinning, M. D., Al‐Dalahmah, O., Banu, M. A., Boehme, A. K., Boubour, A., Bruce, S. S., Chong, A. M., Claassen, J., et al. (2021) · Brain · doi:10.1093/brain/awab148 · Cited by 396
“The average time of death to autopsy was 26 hours (2-177); 31/41 (76%) of the autopsies were performed within 24 hours.”
Background
COVID-19 pandemic—a focused review for clinicians
Çevik, M., Bamford, C., & Ho, A. Y. W. (2020) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2020.04.023 · Cited by 406
Therapeutically administered ribonucleoside analogue MK-4482/EIDD-2801 blocks SARS-CoV-2 transmission in ferrets
Cox, R. M., Wolf, J. D., & Plemper, R. K. (2020) · Nature Microbiology · doi:10.1038/s41564-020-00835-2 · Cited by 391
“A virological study of hospitalized patients with COVID-19 has revealed that the average load of SARS-CoV-2 RNA copies detected in human sputum during the peak phase of infection was 7.0×10 6 (maximum 2.35×10 9 ) copies/ml 29 .”
Influential
Testing for SARS-CoV-2 (COVID-19): a systematic review and clinical guide to molecular and serological in-vitro diagnostic assays
Marca, A. L., Capuzzo, M., Paglia, T., Roli, L., Trenti, T., & Nelson, S. M. (2020) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2020.06.001 · Cited by 394
Molecular Diagnosis of COVID-19: Challenges and Research Needs
Feng, W., Newbigging, A. M., Le, C., Pang, B., Peng, H., Cao, Y., Wu, J., Abbas, G., Song, J., Wang, D., et al. (2020) · Analytical Chemistry · doi:10.1021/acs.analchem.0c02060 · Cited by 390
Inferred duration of infectious period of SARS-CoV-2: rapid scoping review and analysis of available evidence for asymptomatic and symptomatic COVID-19 cases
Byrne, A. W., McEvoy, D., Collins, Á. B., Hunt, K., Casey-Bryars, M., Barber, A. M., Butler, F., Griffin, J., Lane, E. A., McAloon, C. G., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-039856 · Cited by 382
Testing at scale during the COVID-19 pandemic
Mercer, T. R., & Salit, M. (2021) · Nature Reviews Genetics · doi:10.1038/s41576-021-00360-w · Cited by 399
Opportunities and Challenges for Biosensors and Nanoscale Analytical Tools for Pandemics: COVID-19
Bhalla, N., Pan, Y., Yang, Z., & Payam, A. F. (2020) · ACS Nano · doi:10.1021/acsnano.0c04421 · Cited by 392
Detection of SARS-CoV-2 in raw and treated wastewater in Germany – Suitability for COVID-19 surveillance and potential transmission risks
Westhaus, S., Weber, F., Schiwy, S., Linnemann, V., Brinkmann, M., Widera, M., Greve, C., Janke, A., Hollert, H., Wintgens, T., et al. (2020) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2020.141750 · Cited by 381

Authors: Wölfel, R., Corman, V. M., Guggemos, W., Seilmaier, M., Zange, S., Müller, M. A., Niemeyer, D., Jones, T. C., Vollmar, P., Rothe, C., Hoelscher, M., Bleicker, T., Brünink, S., Schneider, J., Ehmann, R., Zwirglmaier, K., Drosten, C., & Wendtner, C.
Affiliations: Institut für Mikrobiologie der Bundeswehr (DE)
Charité – Universitätsmedizin Berlin (DE)
München Klinik Schwabing (DE)
University of Cambridge (GB)
LMU Klinikum (DE)
Corresponding author: Drosten, Christian
Wendtner, Clemens
ORCID: Wölfel, Roman
Corman, Victor M.
Seilmaier, Michael
Zange, Sabine
Müller, Marcel A.
Niemeyer, Daniela
Jones, Terry C.
Bleicker, Tobias
Schneider, Julia
Ehmann, Rosina
Zwirglmaier, Katrin
Drosten, Christian
Wendtner, Clemens
Venue: Nature
Publisher: Springer Science and Business Media LLC
Published: 2020-04-01
Volume: 581
Issue: 7809
Pages: 465-469
ISSN: 0028-0836 (ISSN-L)
1476-4687
DOI: 10.1038/s41586-020-2196-x
OpenAlex: W3013893137
Cited by: 6,661
References: 37
Citations by year: 2026: 92 · 2025: 165 · 2024: 328 · 2023: 526 · 2022: 1091 · 2021: 2228 · 2020: 2219
FWCI: 199.03
Type: journal article
Language: en
Update notices: correction (2020-12-11)
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Nature (publishedVersion)
medRxiv (acceptedVersion)
PubMed (publishedVersion)
RePEc: Research Papers in Economics (submittedVersion)
Funders: European Commission (602525)
Topics: Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 detection and testing
Keywords: COVID-19 pandemic, SARS-CoV-2, upper respiratory tract, viral replication, seroconversion, viral load, hospitalized patients
MeSH terms: Seroconversion, Betacoronavirus, COVID-19, SARS-CoV-2, COVID-19 Testing, Coronavirus Envelope Proteins, Antibodies, Viral, Base Sequence, Blood, Feces, Hospitalization, Humans, Immunoglobulin G, Immunoglobulin M, Lung, Pharynx, Pneumonia, Viral, RNA, Viral, Sputum, Urine, Viral Envelope Proteins, Virus Replication, Virus Shedding, Coronavirus Infections, Clinical Laboratory Techniques, Viral Load, Polymorphism, Single Nucleotide, Pandemics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Virological assessment of hospitalized patients with COVID-2019

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Related

Metadata

Record

About these checks