Symptoms predicting the onset and duration of SARS-CoV-2 infectiousness: A community cohort study
The timing of pSBS aligns with pVL, and pVL above 170,000,000 RNA copies/ml predicts prolonged symptom duration. URT symptom escalation often marks the onset of infectiousness, while systemic symptoms, particularly muscle aches, signal prolonged infectiousness. These findings identify symptom-based markers of infectiousness with implications for testing strategies. They also highlight the importance of collecting early, frequent longitudinal symptom and virological data as a core element of the public health response to novel pathogens and future pandemics.
Authors
- Kieran Madon (ORCID: https://orcid.org/0000-0002-0146-2560)
- Robert Varro (ORCID: https://orcid.org/0000-0001-5526-225X)
- Seran Hakki (ORCID: https://orcid.org/0000-0003-0554-339X)
- M Zambon
- Aleksandra Koycheva
- Timesh D Pillay (ORCID: https://orcid.org/0000-0001-8608-8880)
- Emily Conibear (ORCID: https://orcid.org/0000-0002-3445-6992)
- John Dunning (ORCID: https://orcid.org/0009-0006-2171-4055)
- Jakob Jonnerby (ORCID: https://orcid.org/0009-0001-7862-8645)
- Ajit Lalvani (ORCID: https://orcid.org/0000-0002-2396-246X)
- Janakan Sam Narean (ORCID: https://orcid.org/0000-0002-9572-9501)
- Constanta Luca
- Rhia Kundu
- Joe Fenn
- Hamish Houston
- Nieves Derqui
- Shazaad Ahmad
- Sean Nevin
- Sam Baldwin
- Samuel Evetts
Institutions
- University of Liverpool (GB)
- Manchester Academic Health Science Centre (GB)
- Public Health England (GB)
- University of Oxford (GB)
- Lung Institute (US)
- NIHR Imperial Biomedical Research Centre (GB)
- Health Protection Research Unit in Emerging and Zoonotic Infections at University of Liverpool (GB)
- Imperial College London (GB)
Publication Details
- Journal
- International Journal of Infectious Diseases
- Published
- 2026-02-09
- DOI
- https://doi.org/10.1016/j.ijid.2026.108471
- Primary Topic
- Long-Term Effects of COVID-19
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Institute for Health Research Health Protection Research Unit
- National Institute for Health and Care Research
- Department of Health and Social Care
- Imperial College London
- Medical Research Council