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This pattern of infection is quite distinct from the acute\/resolving nature of other human pathogenic respiratory viruses, such as influenza A virus and respiratory syncytial virus. Prolonged shedding of SARS-CoV-2 furthermore occurs irrespective of disease severity or development of virus-neutralizing antibodies. SARS-CoV-2 possesses an intensely structured RNA genome, an attribute shared with other human and veterinary coronaviruses and with other mammalian RNA viruses such as hepatitis C virus. These are capable of long-term persistence, possibly through poorly understood RNA structure-mediated effects on innate and adaptive host immune responses. The assumption that resolution of COVID-19 and the appearance of anti-SARS-CoV-2 IgG antibodies represents virus clearance and protection from reinfection, implicit for example in the susceptible\u2013infected\u2013recovered (SIR) model used for epidemic prediction, should be rigorously re-evaluated.<\/jats:p>","DOI":"10.1099\/jgv.0.001545","type":"journal-article","created":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T12:15:10Z","timestamp":1608207310000},"source":"Crossref","is-referenced-by-count":27,"title":["Understanding the outcomes of COVID-19 \u2013 does the current model of an acute respiratory infection really fit?"],"prefix":"10.1099","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7964-4700","authenticated-orcid":false,"given":"Peter","family":"Simmonds","sequence":"first","affiliation":[{"name":"Nuffield Department of Medicine, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Williams","sequence":"additional","affiliation":[{"name":"Nuffield Department of Medicine, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9154-4190","authenticated-orcid":false,"given":"Heli","family":"Harvala","sequence":"additional","affiliation":[{"name":"National Microbiology Services, NHS Blood and Transplant, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ486"},{"key":"R2","first-page":"1","article-title":"Understanding viral shedding of SARS-CoV-2: review of current literature","author":"Fontana","year":"2020","journal-title":"Infect Control Hosp Epidemiol"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.03.063"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.21037\/qims.2020.04.08"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004086"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000021865"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2018.06.014"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.02383-14"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.24434"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268814001393"},{"key":"R11","first-page":"431","article-title":"The dynamic relationship between clinical symptomatology and viral shedding in naturally acquired seasonal and pandemic influenza virus infections","volume":"62","author":"DKM","year":"2016","journal-title":"Clin Infect Dis"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwm375"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.00417-16"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz639"},{"key":"R15","first-page":"1","article-title":"Recurrence of SARS-CoV-2 viral RNA in recovered COVID-19 patients: a narrative review","author":"Dao","year":"2020","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"R16","doi-asserted-by":"crossref","DOI":"10.1002\/jmv.25855","article-title":"False negative of RT-PCR and prolonged nucleic acid conversion in COVID-19: rather than recurrence","author":"Xiao","year":"2020","journal-title":"J Med Virol."},{"key":"R17","first-page":"293","article-title":"Duration of viral shedding in asymptomatic or mild cases of novel coronavirus disease 2019 (COVID-19) from a cruise ship: A single-hospital experience in Tokyo, Japan. 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