High prevalence of asymptomatic SARS-CoV-2 infection in a cohort of liver transplant recipients in central Italy
Journal of Liver Transplantation
; 5 (no pagination), 2022.
Article
in English
| EMBASE | ID: covidwho-2305324
ABSTRACT
Asymptomatic subjects account for 25 to 45% of SARS-CoV-2 infections, and in particular, subjects on mild immunosuppressive therapy may have symptoms masked and could spread virus for an extended period of time. To determine the cumulative incidence of symptomatic and asymptomatic SARS-CoV-2 infections and associated risk factors, we conducted a prospective clinical and serological survey in a cohort of 278 liver transplant recipients (LTRs) from Central Italy. Three different serology tests were performed every 4 months in 259 LTRs between April 2020 and April 2021 one based on raw extract of whole SARS-CoV-2 virus and two on specific viral antigens (nucleoprotein and receptor binding domain) to detect specific IgG, IgM and IgA. Hundred fifteen LTRs who reported symptoms or close contact with a SARS-CoV-2-positive subject, or had a positive serological result underwent molecular testing by standard screening procedures (RT-PCR on naso-pharyngeal swab). Thirty-one past or active SARS-CoV-2 infections were identified 14 had positive molecular test (64% symptomatic), and 17 had positive serology only (18% symptomatic). SARS-CoV-2 infection was not statistically related to gender, age, obesity, diabetes, renal impairment, type of anti-rejection therapy or time from transplant. Asymptomatic SARS-CoV-2 cases (61.3%) were more frequent in males and in those with glomerular filtrate rate >50 ml/min. Overall, the addition of repeated serology to standard diagnostic molecular protocols increased detection of SARS-CoV-2 infection from 5.1% to 10.9%. Anti-SARS-CoV-2 seroprevalence among our LTRs (11.2%) is comparable to the general population of Central Italy, considered a medium-impact area. Only one asymptomatic subject (6%) was found to carry SARS-CoV-2 in respiratory tract at the time of serological diagnosis.Copyright © 2021 The Authors
Antibody response; Asymptomatic infection; covid19; Immunosuppressive therapy; Liver transplant recipients; SARS-CoV-2; adult; aged; article; asymptomatic coronavirus disease 2019/di [Diagnosis]; asymptomatic coronavirus disease 2019/ep [Epidemiology]; clinical feature; cohort analysis; controlled study; cumulative incidence; female; gender; glomerulus filtration rate; graft recipient; graft rejection/dt [Drug Therapy]; health survey; human; immunosuppressive treatment; infection risk; Italy; liver graft; major clinical study; male; middle aged; molecular diagnosis; nasopharyngeal swab; nonhuman; observational study; prospective study; protein analysis; protein domain; questionnaire; real time polymerase chain reaction; receptor binding; risk factor; screening test; serology; seroprevalence; Severe acute respiratory syndrome coronavirus 2; virus detection; everolimus/cb [Drug Combination]; everolimus/dt [Drug Therapy]; everolimus/pv [Special Situation for Pharmacovigilance]; immunoglobulin A/ec [Endogenous Compound]; immunoglobulin G/ec [Endogenous Compound]; immunoglobulin M/ec [Endogenous Compound]; mycophenolate mofetil/cb [Drug Combination]; mycophenolate mofetil/dt [Drug Therapy]; mycophenolate mofetil/pv [Special Situation for Pharmacovigilance]; tacrolimus/cb [Drug Combination]; tacrolimus/dt [Drug Therapy]; tacrolimus/pv [Special Situation for Pharmacovigilance]; virus nucleoprotein/ec [Endogenous Compound]; central Italy
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Language:
English
Journal:
Journal of Liver Transplantation
Year:
2022
Document Type:
Article
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