Log in to MyACC
SARS-CoV-2 Transmission Risk in the NBA During 2020 Season
Quick Takes
- Individuals who continue to test positive for SARS-CoV-2 after meeting CDC criteria for discontinuation of isolation were not infectious to others during regular unmasked exposures.
- These results support the safety of the time-based CDC public health recommendations regarding discontinuation of isolation precautions after 10 days from symptom onset or first RT-PCR positive test result, without requiring a negative RT-PCR test result.
- Symptom status and RT-PCR Ct values aid in determining infectiousness among these individuals.
Study Questions:
What are the case characteristics, including viral dynamics and transmission of infection, for individuals who have clinically recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but continued to have positive test results following discontinuation of isolation precautions?
Methods:
The investigators conducted a retrospective cohort study and collected data from June 11, 2020–October 19, 2020, as part of the National Basketball Association (NBA) closed campus occupational health program in Orlando, Florida, which required daily reverse-transcription–polymerase chain reaction (RT-PCR) testing and ad hoc serological testing for SARS-CoV-2 immunoglobulins G (IgG) antibodies. Nearly 4,000 NBA players, staff, and vendors participated in the NBA’s regular and postseason occupational health program in Orlando. Persistent positive cases were those who recovered from a documented SARS-CoV-2 infection, satisfied US Centers for Disease Control and Prevention (CDC) criteria for discontinuation of isolation precautions, and had ≥1 post-infection positive RT-PCR test(s) result. Data on person-days of participation in indoor, unmasked activities that involved direct exposure between persistent positive cases and noninfected individuals were collected. The main outcomes and measures were transmission of SARS-CoV-2 following interaction with persistent positive individuals, as measured by the number of new coronavirus disease 2019 (COVID-19) cases in the Orlando campus program.
Results:
Among 3,648 individuals who participated, 36 (1%) were persistent positive cases, most of whom were <30 years (24 [67%]) and male (34 [94%]). Antibodies were detected in 33 individuals (91.7%); all remained asymptomatic following the index persistent positive RT-PCR result. Cycle threshold values for persistent positive RT-PCR test results were typically above the Roche cobas SARS-CoV-2 limit of detection. Cases were monitored for up to 100 days (mean [standard deviation], 51 [23.9] days), during which there were ≥1,480 person-days of direct exposure activities, with no transmission events or secondary infections of SARS-CoV-2 detected (0 new cases).
Conclusions:
The authors concluded that recovered individuals who continued to test positive for SARS-CoV-2 following discontinuation of isolation were not infectious to others.
Perspective:
This study reports that individuals who continue to test positive for SARS-CoV-2 after meeting CDC criteria for discontinuation of isolation were not infectious to others during regular unmasked exposures. These results support the safety of the time-based CDC public health recommendations regarding discontinuation of isolation precautions after 10 days from symptom onset or first RT-PCR positive test result, without requiring a negative RT-PCR test result. As the pandemic progresses, and particularly if the number of reported reinfection cases increases, interpretation of subsequent positive SARS-CoV-2 RT-PCR test results in recovered individuals will become increasingly challenging. Overall, the current study implies that symptom status and RT-PCR Ct values aid in determining infectiousness among these individuals.
Clinical Topics: COVID-19 Hub, Prevention, Sports and Exercise Cardiology
Keywords: Athletes, Basketball, Coinfection, Coronavirus, Coronavirus Infections, COVID-19, Immunoglobulin G, Primary Prevention, Reverse Transcriptase Polymerase Chain Reaction, SARS-CoV-2, Sports
< Back to Listings
