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Test-based de-isolation in COVID-19 immunocompromised patients: Cycle threshold value versus SARS-CoV-2 viral culture.
Alshukairi, Abeer N; Tolah, Ahmed M; Dada, Ashraf; Al-Tawfiq, Jaffar A; Almagharbi, Reem S; Saeedi, Mohammed F; Al-Hamzi, Mohammed A; El-Kafrawy, Sherif A; Bahaudden, Husam A; El-Saed, Aiman; Al-Mozaini, Maha A; Khalid, Imran; Hefni, Lama K; Hassan, Ahmed M; Alandijany, Thamir A; Bajrai, Leena H; Bayumi, Daniyah T; Albishi, Ghadeer E; Althawadi, Sahar I; Zabani, Najla A; Perlman, Stanley; Azhar, Esam I.
  • Alshukairi AN; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. Electronic address: abeer.alshukairi@gmail.com.
  • Tolah AM; Special Infectious Agents Unit-BSL3, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
  • Dada A; Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
  • Al-Tawfiq JA; Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins Universi
  • Almagharbi RS; Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
  • Saeedi MF; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
  • Al-Hamzi MA; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
  • El-Kafrawy SA; Special Infectious Agents Unit-BSL3, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
  • Bahaudden HA; Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
  • El-Saed A; Department of Infection Prevention and Control, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
  • Al-Mozaini MA; Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
  • Khalid I; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
  • Hefni LK; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
  • Hassan AM; Special Infectious Agents Unit-BSL3, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
  • Alandijany TA; Special Infectious Agents Unit-BSL3, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
  • Bajrai LH; Special Infectious Agents Unit-BSL3, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
  • Bayumi DT; Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
  • Albishi GE; Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
  • Althawadi SI; Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
  • Zabani NA; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
  • Perlman S; Department of Microbiology and Immunology, Department of Pediatrics, University of Iowa, Iowa City, IA, USA.
  • Azhar EI; Special Infectious Agents Unit-BSL3, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
Int J Infect Dis ; 108: 112-115, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1351691
Semantic information from SemMedBD (by NLM)
1. Laboratory Procedures DIAGNOSES Immunocompromised Host
Subject
Laboratory Procedures
Predicate
DIAGNOSES
Object
Immunocompromised Host
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Liver carcinoma PROCESS_OF Patients
Subject
Liver carcinoma
Predicate
PROCESS_OF
Object
Patients
4. Lymphoma PROCESS_OF Patients
Subject
Lymphoma
Predicate
PROCESS_OF
Object
Patients
5. Disease PROCESS_OF Specific population
Subject
Disease
Predicate
PROCESS_OF
Object
Specific population
6. Laboratory Procedures DIAGNOSES Immunocompromised Host
Subject
Laboratory Procedures
Predicate
DIAGNOSES
Object
Immunocompromised Host
7. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
8. Liver carcinoma PROCESS_OF Patients
Subject
Liver carcinoma
Predicate
PROCESS_OF
Object
Patients
9. Lymphoma PROCESS_OF Patients
Subject
Lymphoma
Predicate
PROCESS_OF
Object
Patients
10. Disease PROCESS_OF Specific population
Subject
Disease
Predicate
PROCESS_OF
Object
Specific population
ABSTRACT

BACKGROUND:

Immunocompromised patients with coronavirus disease 2019 (COVID-19) have prolonged infectious viral shedding for more than 20 days. A test-based approach is suggested for de-isolation of these patients.

METHODS:

The strategy was evaluated by comparing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load (cycle threshold (Ct) values) and viral culture at the time of hospital discharge in a series of 13 COVID-19 patients six immunocompetent and seven immunocompromised (five solid organ transplant patients, one lymphoma patient, and one hepatocellular carcinoma patient).

RESULTS:

Three of the 13 (23%) patients had positive viral cultures one patient with lymphoma (on day 16) and two immunocompetent patients (on day 7 and day 11). Eighty percent of the patients had negative viral cultures and had a mean Ct value of 20.5. None of the solid organ transplant recipients had positive viral cultures.

CONCLUSIONS:

The mean Ct value for negative viral cultures was 20.5 in this case series of immunocompromised patients. Unlike those with hematological malignancies, none of the solid organ transplant patients had positive viral cultures. Adopting the test-based approach for all immunocompromised patients may lead to prolonged quarantine. Large-scale studies in disease-specific populations are needed to determine whether a test-based approach versus a symptom-based approach or a combination is applicable for the de-isolation of various immunocompromised patients.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Limits: Humans Language: English Journal: Int J Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Limits: Humans Language: English Journal: Int J Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article