Long-Term Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectiousness Among Three Immunocompromised Patients: From Prolonged Viral Shedding to SARS-CoV-2 Superinfection
- PMID: 33556961
- PMCID: PMC7928754
- DOI: 10.1093/infdis/jiab075
Long-Term Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectiousness Among Three Immunocompromised Patients: From Prolonged Viral Shedding to SARS-CoV-2 Superinfection
Abstract
Background: Guidelines for stopping coronavirus disease 2019 patient isolation are mainly symptom-based, with isolation for 10 to 20 days depending on their condition.
Methods: In this study, we describe 3 deeply immunocompromised patients, each with different clinical evolutions. We observed (1) the patients' epidemiological, clinical, and serological data, (2) infectiousness using viral culture, and (3) viral mutations accumulated over time.
Results: Asymptomatic carriage, symptom resolution, or superinfection with a second severe acute respiratory syndrome coronavirus 2 strain were observed, all leading to prolonged infectious viral shedding for several months.
Conclusions: Understanding underlying mechanisms and frequency of prolonged infectiousness is crucial to adapt current guidelines and strengthen the use of systematic polymerase chain reaction testing before stopping isolation in immunocompromised populations.
Keywords: COVID-19; SARS-CoV-2; immunocompromised patients; isolation; viral shedding.
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
Comment in
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Evolution of a 7-Mutant Strain of SARS-CoV-2 Within an Immunocompromised Person May Elucidate the Mechanism for the Generation of New Variants.J Infect Dis. 2023 Feb 14;227(4):602. doi: 10.1093/infdis/jiac083. J Infect Dis. 2023. PMID: 35255135 Free PMC article. No abstract available.
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