Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Apr;26(4):328-332.
doi: 10.1111/nep.13844. Epub 2020 Dec 23.

Prolonged SARS-CoV-2 viral shedding in patients with chronic kidney disease

Eoin D O'Sullivan  1 , Jennifer S Lees  2 , Katie L Howie  1 , Dan Pugh  1 , Keith A Gillis  2 , Jamie P Traynor  2 , Iain Macintyre  1 , Patrick B Mark  2
Affiliations
Free article
Observational Study

Prolonged SARS-CoV-2 viral shedding in patients with chronic kidney disease

Eoin D O'Sullivan et al. Nephrology (Carlton). 2021 Apr.
Free article

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.

Keywords: CKD; SARS-CoV-2; viral shedding.

PubMed Disclaimer

References

REFERENCES

    1. World Health Organisation. Criteria for releasing COVID-19 patients from isolation. https://www.who.int/news-room/commentaries/detail/criteria-for-releasing.... 2020. Accessed July 15, 2020.
    1. Widders A, Broom A, Broom J. SARS-CoV-2: the viral shedding vs infectivity dilemma. Infect Dis Heal. 2020;25:210-215. https://doi.org/10.1016/j.idh.2020.05.002.
    1. Xu K, Chen Y, Yuan J, et al. Factors associated with prolonged viral RNA shedding in patients with coronavirus disease 2019 (COVID-19). Clin Infect Dis. 2020;71:799-806. https://doi.org/10.1093/cid/ciaa351.
    1. Choi B, Choudhary MC, Regan J, et al. Persistence and Evolution of SARS-CoV-2 in an Immunocompromised Host. N Engl J Med. 2020;383(23):2291-2293. https://doi.org/10.1056/nejmc2031364.
    1. Cevik M, Tate M, Lloyd O, Maraolo AE, Schafers J, Ho A. SARS-CoV-2 viral load dynamics, duration of viral shedding and infectiousness: a living systematic review and meta-analysis. medRxiv. 2020. https://doi.org/10.1101/2020.07.25.20162107.

Publication types

MeSH terms