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. 2021 Jul 1;105(7):1445-1448.
doi: 10.1097/TP.0000000000003695.

Cycle Thresholds Among Solid Organ Transplant Recipients Testing Positive for SARS-CoV-2

Deborah A Theodore  1 , William G Greendyke  1 , Benjamin Miko  1 , Susan Whittier  2 , Daniel A Green  2 , Sherif Shoucri  1 , Elizabeth C Verna  3 , Jason Zucker  1   4 , Magdalena E Sobieszczyk  1 , Justin G Aaron  1 , Brian E Scully  1 , Lisa Saiman  4   5 , Marcus Pereira  1 , E Yoko Furuya  1   5
Affiliations

Cycle Thresholds Among Solid Organ Transplant Recipients Testing Positive for SARS-CoV-2

Deborah A Theodore et al. Transplantation. .

Abstract

Background: The optimal duration of transmission-based precautions among immunocompromised patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unknown.

Methods: Retrospective review of patients with solid organ transplant with positive SARS-CoV-2 polymerase chain reaction result from nasopharyngeal specimens admitted to the hospital between March 13, 2020 and May 15, 2020.

Results: Twenty-one percent of solid organ transplant recipients with positive SARS-CoV-2 polymerase chain reaction detected ≥20 d after symptom onset (or after first positive test among asymptomatic individuals) had a low cycle threshold (ie, high viral load). The majority of these patients were asymptomatic or symptomatically improved.

Conclusions: Solid organ transplant recipients may have prolonged high viral burden of SARS-CoV-2. Further data are needed to understand whether cycle threshold data can help inform strategies for prevention of healthcare-associated transmission of SARS-CoV-2 and for appropriate discontinuation of transmission-based precautions.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Cycle threshold (Ct) for the E-gene over time. Day 0 is the day of symptom onset (or the first positive test if the patient was asymptomatic). Negative SARS-CoV-2 PCR tests are shown at the bottom of the figure on line “Not detected”.
Figure 2.
Figure 2.
Flowchart of patients.
See this image and copyright information in PMC

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