Prolonged Viable Viral Shedding in Immunocompromised Patients with Covid-19
Topics in Antiviral Medicine
; 31(2):288, 2023.
Article
in English
| EMBASE | ID: covidwho-2315900
ABSTRACT
Background:
Immunocompromised patients with COVID-19 tend to shed viable virus for a prolonged period. Therefore, for moderately or severely immunocompromised patients with COVID-19, CDC recommends an isolation period of at least 20 days and ending isolation in conjunction with serial testing and consultation with an infectious disease specialist. However, data on viral kinetics and risk factors for prolonged viral shedding in these patients are limited. Method(s) From February 1, 2022 to April 1, 2022, we collected weekly saliva samples from immunocompromised patients with COVID-19 admitted to a tertiary hospital in Seoul, South Korea. Genomic and subgenomic RNAs were measured, and virus culture was performed. Result(s) A total of 41 patients were enrolled;29 (70%) were receiving chemotherapy against hematologic malignancies and the remaining 12 (30%) had undergone solid organ transplantation. Of the 41 patients, 14 (34%) had received 3 doses or more of COVID-19 vaccines. Real-time RT-PCR revealed that 7 (17%) were infected with Omicron BA.1, and 33 (80%) with Omicron BA.2. The median duration of viable virus shedding was 4 weeks (IQR 3-6). Patients undergoing B-cell depleting therapy shed viable virus for longer than the comparator (p=0.01). Multivariable analysis showed that 3-dose or more vaccination (HR 0.33, 95% CI 0.12 - 0.93, p = 0.04) and B-cell depleting therapy (HR 12.50, 95% CI 2.44 - 100.00, p = 0.003) independently affected viable virus shedding of SARS-CoV-2. Conclusion(s) Immunocompromised patients with COVID-19 shed viable virus for median 4 weeks. B-cell depleting therapy increases the risk of prolonged viable viral shedding, while completion of a primary vaccine series reduces this risk. Overall distribution of samples according to genomic viral copy number and culture positivity. Red dot indicates positive culture results, whereas blue dot indicated negative culture results. (Figure Presented).
adult; B lymphocyte; cancer patient; chemotherapy; clinical article; conference abstract; controlled study; coronavirus disease 2019; drug therapy; female; hematologic malignancy; human; human cell; human tissue; immunocompromised patient; male; nonhuman; organ transplantation; real time reverse transcription polymerase chain reaction; saliva; Severe acute respiratory syndrome coronavirus 2; South Korea; surgery; tertiary care center; vaccination; virus culture; virus shedding; SARS-CoV-2 vaccine; subgenomic mRNA
Search on Google
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Topics in Antiviral Medicine
Year:
2023
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS