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Prolonged SARS-CoV-2 viral shedding in patients with chronic kidney disease.
O'Sullivan, Eoin D; Lees, Jennifer S; Howie, Katie L; Pugh, Dan; Gillis, Keith A; Traynor, Jamie P; Macintyre, Iain; Mark, Patrick B.
  • O'Sullivan ED; Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Lees JS; Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.
  • Howie KL; Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Pugh D; Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Gillis KA; Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.
  • Traynor JP; Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.
  • Macintyre I; Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Mark PB; Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.
Nephrology (Carlton) ; 26(4): 328-332, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-991640
ABSTRACT
Recent World Health Organization guidance has aimed to provide pragmatic guidance acknowledging the role of sequential nasopharyngeal swabs taken >24 hours apart for SARS-CoV-2 in high-risk populations. Patients with chronic kidney disease (CKD) are known to have an altered immune milieu which may be associated with a delay in viral clearance. Here, a cross-sectional observational study of 138 patients admitted with SARS-CoV-2 infection at two large regional hospitals in Scotland, UK examined the median time to two consecutive negative nasopharyngeal swabs for SARS-CoV-2 in an inpatient population. The median time from admission to the first of two consecutive negative nasopharyngeal swabs was 18 days (range = 1-44) in patients with CKD, compared with 11 days (range 1-71) in patients without CKD (P = .0007). Multivariable linear regression analysis using explanatory variables of age, sex, SARS-CoV-2 disease severity, key comorbidities and renal function showed that declining estimated glomerular filtration rate was independently associated with prolonged time to viral clearance. Our data suggest that patients with CKD who are admitted to hospital with SARS-CoV-2 take longer to achieve sequential negative nasopharyngeal swab reverse transcription-polymerase chain reaction results than those without CKD. This has implications for renal service provision, discharge planning and hospital capacity as well as a direct impact on patients due to extended hospital stay, anxiety and stigmatisation.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Virus Shedding / Renal Insufficiency, Chronic / COVID-19 Nucleic Acid Testing / SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Nephrology (Carlton) Journal subject: Nephrology Year: 2021 Document Type: Article Affiliation country: Nep.13844

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Virus Shedding / Renal Insufficiency, Chronic / COVID-19 Nucleic Acid Testing / SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Nephrology (Carlton) Journal subject: Nephrology Year: 2021 Document Type: Article Affiliation country: Nep.13844