Background RT-PCR has become the primary method to diagnose viral diseases, including SARS-CoV-2. RT-PCR detects RNA, not infectious virus, thus its ability to determine duration of infectivity of patients is limited. Infectivity is a critical determinant in informing public health guidelines/interventions. Our goal was to determine the relationship between E gene SARS-CoV-2 RT-PCR cycle threshold (Ct) values from respiratory samples, symptom onset to test (STT) and infectivity in cell culture. Methods In this retrospective cross-sectional study, we took SARS-CoV-2 RT-PCR confirmed positive samples and determined their ability to infect Vero cell lines. Results Ninety RT-PCR SARS-CoV-2 positive samples were incubated on Vero cells. Twenty-six samples (28.9%) demonstrated viral growth. Median TCID50/ml was 1780 (282-8511). There was no growth in samples with a Ct > 24 or STT > 8 days. Multivariate logistic regression using positive viral culture as a binary predictor variable, STT and Ct demonstrated an odds ratio for positive viral culture of 0.64 (95% CI 0.49-0.84, p<0.001) for every one unit increase in Ct. Area under the receiver operating characteristic curve for Ct vs. positive culture was OR 0.91 (95% CI 0.85-0.97, p<0.001), with 97% specificity obtained at a Ct of >24. Conclusions SARS-CoV-2 Vero cell infectivity was only observed for RT-PCR Ct < 24 and STT < 8 days. Infectivity of patients with Ct >24 and duration of symptoms >8 days may be low. This information can inform public health policy and guide clinical, infection control and occupational health decisions. Further studies of larger size are needed.

The lipid-rich cell wall is a defining feature of Mycobacterium species. Individual cell wall components affect diverse mycobacterial phenotypes including colony morphology, biofilm formation, antibiotic resistance, and virulence. In this study, we describe a transposon insertion mutant of Mycobacterium smegmatis mc 2 155 that exhibits altered colony morphology and defects in biofilm formation. The mutation was localized to the lsr2 gene. First identified as an immunodominant T-cell antigen of Mycobacterium leprae, lsr2 orthologs have been identified in all sequenced mycobacterial genomes, and homologs are found in many actinomycetes. Although its precise function remains unknown, localization experiments indicate that Lsr2 is a cytosolic protein, and cross-linking experiments demonstrate that it exists as a dimer. Characterization of cell wall lipid components reveals that the M. smegmatis lsr2 mutant lacks two previously unidentified apolar lipids. Characterization by mass spectrometry and thin-layer chromatography indicate that these two apolar lipids are novel mycolatecontaining compounds, called mycolyl-diacylglycerols (MDAGs), in which a mycolic acid (␣-or ␣-mycolate) molecule is esterified to a glycerol. Upon complementation with an intact lsr2 gene, the mutant reverts to the parental phenotypes and MDAG production is restored. This study demonstrates that due to its impact on the biosynthesis of the hydrophobic MDAGs, Lsr2 plays an important role in the colony morphology and biofilm formation of M. smegmatis.The cell wall is a defining feature of mycobacteria. This complex, lipid-rich, hydrophobic structure is responsible for the acid-fast staining properties, distinctive colony morphology, and innate antibiotic resistance of Mycobacterium species (12,25,28). Among pathogens, including Mycobacterium tuberculosis, the causative agent of tuberculosis, cell wall components contribute to virulence, persistence within macrophages, and modulation of the host immune response (16, 45).The cell wall forms an asymmetric lipid bilayer (25,28). The inner leaflet is composed of mycolic acids that are covalently bound to arabinogalactan, which is further linked to peptidoglycan via a phosphodiester bridge (12). The outer leaflet contains a variety of lipid components (26,28). In total, lipids comprise 60% (wt/wt) of the cell wall (12, 25). In addition to mycolic acids, various types of complex lipids are present in the cell wall. These include lipoglycans (e.g., lipoarabinomannan [LAM]), trehalose-containing glycolipids, phthiocerol dimycocerosates, phenolic glycolipids, and glycopeptidolipids (GPLs) (12, 25). The distribution of these lipids varies among mycobacterial species (12). Triacylglycerols (TAGs) are also present in the mycobacterial cell wall (35) and are thought to fill the gap between the meromycolate arm and the shorter ␣-chain of mycolic acids (28). Different lipids appear to have different roles. For example, LAM from M. tuberculosis, but not the structurally distinct LAM of nonpathogenic mycobacteria,...