[The Lancet Infectious Diseases] SARS-CoV-2 shedding and seroconversion among passengers quarantined after disembarking a cruise ship: a case series

The Lancet Infectious Diseases, 12 June 2020

Ivan Fan-Ngai Hung, Vincent Chi-Chung Cheng, Xin Li, Anthony Raymond Tam, Derek Ling-Lung Hung, Kelvin Hei-Yeung Chiu, Cyril Chik-Yan Yip, Jian-Piao Cai, Deborah Tip-Yin Ho, Shuk-Ching Wong, Sally Sau-Man Leung, Man-Yee Chu, Milky Oi-Yan Tang, Jonathan Hon-Kwan Chen, Rosana Wing-Shan Poon, Agnes Yim-Fong Fung, Ricky Ruiqi Zhang, Erica Yuen-Wing Yan, Lin-Lei Chen, Charlotte Yee-Ki Choi, Kit-Hang Leung, Tom Wai-Hin Chung, Sonia Hiu-Yin Lam, Tina Poy-Wing Lam, Jasper Fuk-Woo Chan, Kwok-Hung Chan, Tak-Chiu Wu, Pak-Leung Ho, Johnny Wai-Man Chan, Chak-Sing Lau, Kelvin Kai-Wang To, Kwok-Yung Yuen

Funded by Shaw Foundation Hong Kong; Sanming-Project of Medicine (Shenzhen); High Level-Hospital Program (Guangdong Health Commission).


  • Adult (≥18 years) passengers from Hong Kong who had been on board the Diamond Princess cruise ship were recruited in the study. All participants had been found to be negative for SARS-CoV-2 by RT-PCR 4 days before disembarking the ship.
  • 215 adults were recruited, of whom nine (4%; 95% CI 2–8) were positive for SARS-CoV-2 by RT-qPCR or serology and were hospitalised.
  • Participants were prospectively screened by quantitative RT-PCR (RT-qPCR) of nasopharyngeal and throat swabs, and serum IgG and IgM against internal nucleoprotein and the surface spike receptor-binding protein (RBD) of SARS-CoV-2 at baseline (upon entering quarantine) and on days 4, 8, and 12 of quarantine.
  • Patients with COVID-19 can develop asymptomatic lung infection with viral shedding and those with evidence of pneumonia on imaging tend to have an increased antibody response.
  • Positive IgG or IgM confirmed infection of COVID-19 in both symptomatic and asymptomatic patients

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