Severe relapse of SARS-CoV-2 infection in a kidney transplant recipient with negative nasopharyngeal SARS-CoV-2 RT-PCR after rituximab.
Am J Transplant
; 22(8): 2099-2103, 2022 08.
Artículo
en Inglés
| MEDLINE | ID: covidwho-1685185
ABSTRACT
Immunocompromised patients may experience prolonged viral shedding after their initial SARS-CoV-2 infection, however, symptomatic relapses after remission currently remain rare. We herein describe a severe COVID-19 relapse case of a kidney transplant recipient (KTR) following rituximab therapy, 3 months after a moderate COVID-19 infection, despite viral clearance after recovery of the first episode. During the clinical relapse, the diagnosis was established on a broncho-alveolar lavage specimen (BAL) by RT-PCR. The infectivity of the BAL sample was confirmed on a cell culture assay. Whole genome sequencing confirmed the presence of an identical stain (Clade 20A). However, it had an acquired G142D mutation and a larger deletion of 3-amino-acids at position 143-145. These mutations located within the N-terminal domain are suggested to play a role in viral entry. The diagnosis of a COVID-19 relapse should be considered in the setting of unexplained persistent fever and/or respiratory symptoms in KTRs (especially for those after rituximab therapy), even in patients with previous negative naso-pharyngeal SARS-CoV-2 PCR.
Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Trasplante de Riñón
/
COVID-19
Tipo de estudio:
Reporte de caso
/
Estudios diagnósticos
/
Estudio pronóstico
Tópicos:
Covid persistente
Límite:
Humanos
Idioma:
Inglés
Revista:
Am J Transplant
Asunto de la revista:
Trasplante
Año:
2022
Tipo del documento:
Artículo
País de afiliación:
Ajt.17000
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