{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T07:14:17Z","timestamp":1783322057977,"version":"3.54.6"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"unspecified","delay-in-days":125,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We sought to assess predictive factors for SARS-CoV-2 infectiousness using a meta-analytic approach. We searched LitCovid, medRxiv, Google Scholar, and the WHO COVID-19 database until June 30 2025, including studies which cultured SARS-CoV-2, relating them to clinico-epidemiologic and laboratory variables and RT-PCR cycle threshold (Ct) values. Using linear mixed-effects regression models, we tested for independent associations with Ct values with 95%CIs and adjusted\n                    <jats:italic>P<\/jats:italic>\n                    -values in a multivariable model. We used a modified QUADAS criteria to assess risk-of-bias. We included 50 studies, with 39 in quantitative synthesis. The percentage of culture-positive specimens decreased with increasing Ct values (subgroup test difference Q\u00a0=\u00a096.71;\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0&lt;\u00a00.001) and time since the first PCR test (Q\u00a0=\u00a026.95;\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.0026). Presence of symptoms (Q\u00a0=\u00a020.1;\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0&lt;\u00a00.01), gene platform used (Q\u00a0=\u00a014.89;\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.002), being a cancer patient (Q\u00a0=\u00a024.9;\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0&lt;\u00a00.0001), and vaccination status (Q\u00a0=\u00a08.80;\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.012) were associated with increased culture-positivity, whereas a rising Ct (adjusted Ct change \u22126.58[95%CI] -5.30, \u22127.86;\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0&lt;\u00a00.001) was strongly associated with culture-negativity. Analysing 186 immunocompetent patients with 1,393 Ct values, 2 consecutive Cts\u00a0\u2265\u00a030 or a rising Ct value on serial testing demonstrated a sensitivity of 87.5% and specificity of 96.3% using culture positivity as the outcome. Serial Ct monitoring, integrated with clinico-epidemiologic data is a valuable tool for assessing infectiousness, providing objective criteria for discontinuing isolation and guiding clinical decisions.\n                  <\/jats:p>","DOI":"10.1017\/s0950268826101484","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T08:29:31Z","timestamp":1778056171000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Serial cycle threshold to assess the infectious potential of SARS-CoV-2: A systematic review"],"prefix":"10.1017","volume":"154","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2412-1942","authenticated-orcid":false,"given":"Elena Cecilia","family":"Rosca","sequence":"first","affiliation":[{"name":"Victor Babes University of Medicine and Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Oke","sequence":"additional","affiliation":[{"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Jefferson","sequence":"additional","affiliation":[{"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Brassey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igho","family":"Onakpoya","sequence":"additional","affiliation":[{"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Pl\u00fcddemann","sequence":"additional","affiliation":[{"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1348-4548","authenticated-orcid":false,"given":"Sara","family":"Gandini","sequence":"additional","affiliation":[{"name":"IEO European Institute of Oncology IRCCS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Maltoni","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria di Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Evans","sequence":"additional","affiliation":[{"name":"University of Alberta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Conly","sequence":"additional","affiliation":[{"name":"University of Calgary and Alberta Health Services"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Heneghan","sequence":"additional","affiliation":[{"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,5,6]]},"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268826101484","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:20:37Z","timestamp":1783318837000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268826101484\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"alternative-id":["S0950268826101484"],"URL":"https:\/\/doi.org\/10.1017\/s0950268826101484","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e89"}}