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. 2021 Jul:108:112-115.
doi: 10.1016/j.ijid.2021.05.027. Epub 2021 May 15.

Test-based de-isolation in COVID-19 immunocompromised patients: Cycle threshold value versus SARS-CoV-2 viral culture

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Test-based de-isolation in COVID-19 immunocompromised patients: Cycle threshold value versus SARS-CoV-2 viral culture

Abeer N Alshukairi et al. Int J Infect Dis. 2021 Jul.

Abstract

Background: Immunocompromised patients with coronavirus disease 2019 (COVID-19) have prolonged infectious viral shedding for more than 20 days. A test-based approach is suggested for de-isolation of these patients.

Methods: The strategy was evaluated by comparing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load (cycle threshold (Ct) values) and viral culture at the time of hospital discharge in a series of 13 COVID-19 patients: six immunocompetent and seven immunocompromised (five solid organ transplant patients, one lymphoma patient, and one hepatocellular carcinoma patient).

Results: Three of the 13 (23%) patients had positive viral cultures: one patient with lymphoma (on day 16) and two immunocompetent patients (on day 7 and day 11). Eighty percent of the patients had negative viral cultures and had a mean Ct value of 20.5. None of the solid organ transplant recipients had positive viral cultures.

Conclusions: The mean Ct value for negative viral cultures was 20.5 in this case series of immunocompromised patients. Unlike those with hematological malignancies, none of the solid organ transplant patients had positive viral cultures. Adopting the test-based approach for all immunocompromised patients may lead to prolonged quarantine. Large-scale studies in disease-specific populations are needed to determine whether a test-based approach versus a symptom-based approach or a combination is applicable for the de-isolation of various immunocompromised patients.

Keywords: Immunocompromised patients; Isolation; SARS-CoV-2; Viral culture.

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Figures

Figure 1
Figure 1
Graph showing patients with negative cultures (n = 10) and the percentage of those with a Ct value >24 and a Ct value <24 among immunocompetent and immunocompromised patients.

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References

    1. Azhar E.I., Hindawi S.I., El-Kafrawy S.A., Hassan A.M., Tolah A.M., Alandijany T.A. Amotosalen and ultraviolet A light treatment efficiently inactivates severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) in human plasma. Vox Sanguinis. 2020;(December) doi: 10.1111/vox.13043. - DOI - PMC - PubMed
    1. Baang J.H., Smith C., Mirabelli C., Valesano A.L., Manthei D.M., Bachman M.A. Prolonged severe acute respiratory syndrome coronavirus 2 replication in an immunocompromised patient. J Infect Dis. 2021;223:23–27. - PMC - PubMed
    1. Basile K., McPhie K., Carter I., Aderson S., Rahman H., Donovan L. Cell-based culture of SARS-CoV-2 informs infectivity and safe de-isolation assessments during COVID-19. Clin Infect Dis. 2020;(October) doi: 10.1093/cid/ciaa1579. - DOI - PMC - PubMed
    1. Bullard J., Dust K., Funk D., Strong J.E., Alexander D., Garnett L. Predicting infectious severe acute respiratory syndrome coronavirus 2 from diagnostic samples. Clin Infect Dis. 2020;71(December (10)):2663–2666. - PMC - PubMed
    1. Bulterys P.L., Garamani N., Stevens B., Sahoo M.K., Huang C., Hogan C.A. Comparison of a laboratory-developed test targeting the envelope gene with three nucleic acid amplification tests for detection of SARS-CoV-2. J Clin Virol. 2020;129 - PMC - PubMed