Welcome to the CCO Site

Thank you for your interest in CCO content. As a guest, please complete the following information fields. These data help ensure our continued delivery of impactful education. 

Become a member (or login)? Member benefits include accreditation certificates, downloadable slides, and decision support tools.


Frequently Asked Questions on Diagnosis, Transmission, and Epidemiology of SARS-CoV-2

David Heymann, BA, MD, DTM&H
Sharon R. Lewin, AO, FRACP, PhD, FAHMS
Jens D. Lundgren, MD, DMSc
Vikramjit Mukherjee, MD
Paul E. Sax, MD
Lynora Saxinger, MD, FRCPC, CTropMed
Released: July 8, 2020
Back Next


Anand S, Montez-Rath M, Han J, et al. Prevalence of SARS-CoV-2 antibodies in a large nationwide sample of patients on dialysis in the USA: a cross-sectional study. Lancet. 2020;396;1335.

Bobay LM, O’Donnell AC, Ochman H. Recombination events are concentrated in the spike protein region of Betacoronaviruses. PLoS Genet. 2020;16:e1009272.

Buonsenso D, De Rose C, Moroni R, et al. SARS-CoV-2 infections in Italian schools: preliminary findings after one month of school opening during the second wave of the pandemic. medRxiv. October 11, 2020. Available at: https://www.medrxiv.org/content/10.1101/2020.10.10.20210328v1. Accessed April 4, 2021.

Callaway E. The coronavirus is mutating - does it matter? Nature. 2020;585:174-177.

Centers for Disease Control and Prevention. New COVID-19 variants. January 15, 2021. Available at: https://www.cdc.gov/coronavirus/2019-ncov/transmission/variant.html. Accessed April 4, 2021.

Centers for Disease Control and Prevention. Interim: implications of the emerging SARS-CoV-2 variant VOC 202012/01. December 29, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-emerging-variant.html. Accessed April 4, 2021.

Centers for Disease Control and Prevention. Symptoms of coronavirus. Updated December 22, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html. Accessed April 4, 2021.

Centers for Disease Control and Prevention. COVID-19 pandemic planning scenarios. Updated September 10, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html. Accessed April 4, 2021.

Centers for Disease Control and Prevention. Operational considerations for adapting a contact tracing program to respond to the COVID-19 pandemic. Updated December 9, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/operational-considerations-contact-tracing.html. Accessed April 4, 2021.

Centers for Disease Control and Prevention. Duration of isolation and precautions for adults with COVID-19. Updated October 19, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html. Accessed April 4, 2021.

Centers for Disease Control and Prevention. Public health guidance for community-related exposure. Updated December 3, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/php/public-health-recommendations.html. Accessed April 4, 2021.

Centers for Disease Control and Prevention. How to protect yourself & others. Updated December 31, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. Accessed April 4, 2021.

Centers for Disease Control and Prevention. Interim guidance for use of pooling procedures in SARS-CoV-2 diagnostic, screening, and surveillance testing. Updated October 23, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/lab/pooling-procedures.html. Accessed April 4, 2021.

Cheng HW, Jian SW, Liu DP, et al. Contact tracing assessment of COVID-19 transmission dynamics in Taiwan and risk at different exposure periods before and after symptom onset. JAMA Intern Med. 2020;180:1156.

Choi B, Choudhary MC, Regan J, et al. Persistence and evolution of SARS-CoV-2 in an immunocompromised host. N Engl J Med. 2020;383:2291-2293.

Dagan M, Barda, M, Kepten E, et al. BNT162b2 mRNA COVID-19 vaccine in a nationwide mass vaccination setting. N Engl J Med. 2021;[Epub ahead of print].

European Centre for Disease Prevention and Control. Risk related to the spread of new SARS-CoV-2 variants of concern in the EU/EEA – first update. January 21, 2021. Available at: https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-risk-related-to-spread-of-new-SARS-CoV-2-variants-EU-EEA-first-update.pdf. Accessed April 4, 2021.

Foundation for Innovative New Diagnostics. COVID-19 diagnostics & testing. Available at: https://www.finddx.org/covid-19/. Accessed April 4, 2021.

Gandhi M, Yokoe DS, Havlir DV. Asymptomatic transmission, the Achilles’ heel of current strategies to control Covid-19. N Engl J Med. 2020;382:2158.

GISAID. Available at: https://www.gisaid.org/epiflu-applications/phylodynamics/. Accessed April 4, 2021.

Ioannidis JPA. Infection fatality rate of COVID-19 inferred from seroprevalence data. Bulletin of the World Health Organization;BLT.20.265892. Available at: https://www.who.int/bulletin/online_first/BLT.20.265892.pdf. Accessed April 4, 2021.

Ismail SA, Saliba V, Lopez Bernal, J, et al. SARS-CoV-2 infection and transmission in educational settings: cross-sectional analysis of clusters and outbreaks in England. medRxiv. August 24, 2020. Available at: https://www.medrxiv.org/content/10.1101/2020.08.21.20178574v1. Accessed April 4, 2021.

Korea Centers for Disease Control and Prevention. Findings from investigation and analysis of re-positive cases. May 19, 2020. Available at: https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030&act=view&list_no=367267&nPage=1. Accessed April 4, 2021.

Kwok KO, Lai F, Wei WI, et al. Herd immunity—estimating the level required to halt the COVID-19 epidemics in affected countries. J Infect. 2020;80:e32.

Lauer SA, Grantz KH, Bi Q, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Ann Intern Med. 2020;172:577-582.

Li N, Wang X, Lv T. Prolonged SARS‐CoV‐2 RNA shedding: not a rare phenomenon. J Med Virol. 2020a;92:2286-2287.

Li Y, Yao L, Li J, et al. Stability issues of RT‐PCR testing of SARS‐CoV‐2 for hospitalized patients clinically diagnosed with COVID‐19. J Med Virol. 2020b;92:903-908.

Long QX, Tang XJ, Shi QL, et al. Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections. Nat Med. 2020a;10.1038/s41591-020-0965-6.

Long Q-X, Liu B-Z, Deng H-J, et al. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med. 2020b;26:845-848.

Manzanares-Meza LD, Medina-Contreras O. SARS-CoV-2 and influenza: a comparative overview and treatment implications. Bol Med Hosp Infant Mex. 2020;77:262-273.

Olson SJ, Azziz-Baumgartner E, Budd AP, et al. Decreased influenza activity during the COVID-19 pandemic—United States, Australia, Chile, and South Africa, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1305-1309.

Otte Im Kampe E, Lehfeld AS, Buda S, et al. Surveillance of COVID-19 school outbreaks, Germany, March to August 2020. Euro Surveill. 2020;25:2001645.

Plante JA, Liu Y, Liu J, et al. Spike mutation D614G alters SARS-CoV-2 fitness. Nature. 2021;592:116-121.

Pollán M, Pérez-Gómez B, Pastor-Barriuso R, et al. Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study. Lancet. 2020;396:535.

Premraj A, Aleyas AG, Nautiyal B, et al. Nucleic Acid and Immunological Diagnostics for SARS-CoV-2: Processes, Platforms and Pitfalls. Diagnostics (Basel). 2020;10:866.

Public Health Agency of Canada. Public health management of cases and contacts associated with COVID-19. Updated December 23, 2020. Available at: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/interim-guidance-cases-contacts.html. Accessed April 4, 2021.

Randolph HE, Barreiro LB. Herd immunity: understanding COVID-19. Immunity. 2020;52:737.

Robbiani DF, Gaebler C, Muecksch F, et al. Convergent antibody responses to SARS-CoV-2 in convalescent individuals. Nature. 2020;584:437-442.

Rostami A, Sepidarkish M, Leeflang MMG, et al. SARS-CoV-2 seroprevalence worldwide: a systematic review and meta-analysis. Clin Microbiol Infect. 2020;27:331-340.

Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N Engl J Med. 2020;382:970.

Russell FM, Ryan K, Snow K, et al. COVID-19 in Victorian Schools: an analysis of child-care and school outbreak data and evidence-based recommendations for opening schools and keeping them open. Melbourne, Australia: Murdoch Children’s Research Institute and the University of Melbourne; 25 September, 2020. Available at: https://www.dhhs.vic.gov.au/sites/default/files/documents/202009/Report-summary-COVID-19-in-victorian-schools-pdf.pdf. Accessed April 4, 2021.

US Food and Drug Administration. Coronavirus (COVID-19) update: FDA issues Emergency Use Authorization to Yale School of Public Health for SalivaDirect, which uses a new method of saliva sample processing. Available at: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-yale-school-public-health. Accessed April 4, 2021.

Vogels CBV, Brackney DE, Wang J, et al. SalivaDirect: simple and sensitive molecular diagnostic test for SARS-CoV-2 surveillance. Available at: https://www.medrxiv.org/content/10.1101/2020.08.03.20167791v1.full.pdf. Accessed April 4, 2021. Note: This study has not been peer reviewed.

Volz EM, Hill V, McCrone JT, et al. Evaluating the effects of SARS-CoV-2 Spike mutation D614G on transmissibility and pathogenicity. medRxiv. September 1, 2020. Available at: https://www.medrxiv.org/content/10.1101/2020.07.31.20166082v2. Accessed April 4, 2021.

Wang Y, Zhang L, Sang L, et al. Kinetics of viral load and antibody response in relation to COVID-19 severity. J Clin Invest. 2020a;138759.

Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA. 2020b;323:1843-1844

Ward H, Cooke G, Atchison C, et al. Declining prevalence of antibody positivity to SARS-CoV-2: a community study of 365,000 adults. medRxiv. October 27, 2020. Available at: https://www.medrxiv.org/content/10.1101/2020.10.26.20219725v1. Accessed April 4, 2021.

Weekes M, Jones, NK, Rivett L, et al. Single-dose BNT162b2 vaccine protects against asymptomatic SARS-CoV-2 infection. Available at: https://www.authorea.com/users/332778/articles/509881-single-dose-bnt162b2-vaccine-protects-against-asymptomatic-sars-cov-2-infection?commit=3947109177a9e05258812c5566ab91f44c3e08e6. Accessed April 4, 2021. Note: This study has not been peer reviewed.

Woloshin S, Neeraj P, Kesselheim AS. False negative tests for SARS-CoV-2 infection—challenges and Implications. N Engl J Med. 2020;383:e38.

World Health Organization. Criteria for releasing COVID-19 patients from isolation: scientific brief. Available at: https://www.who.int/publications/i/item/criteria-for-releasing-covid-19-patients-from-isolation. Accessed April 4, 2021.

Xiao F, Sun J, Xu Y, et al. Infectious SARS-CoV-2 in Feces of Patient with Severe COVID-19. Emerg Infect Dis. 2020;26:1920-1922.

Yang Y, Yang M, Shen C, et al. Evaluating the accuracy of different respiratory specimens in the laboratory diagnosis and monitoring the viral shedding of 2019-nCoV infections. medRxiv. 2020;[Preprint]. Note: This study has not been peer reviewed.

Young BE, Fong SW, Chan YH, et al. Effects of a major deletion in the SARS-CoV-2 genome on the severity of infection and the inflammatory response: an observational cohort study. Lancet. 2020;396:603-611.

Back Next
Provided by Clinical Care Options, LLC

Contact Clinical Care Options

For customer support please email: customersupport@cealliance.com

Mailing Address
Clinical Care Options, LLC
12001 Sunrise Valley Drive
Suite 300
Reston, VA 20191

Educational grant provided by
Gilead Sciences, Inc.

Leaving the CCO site

You are now leaving the CCO site. The new destination site may have different terms of use and privacy policy.