AI Article Synopsis

  • Immunocompromised patients are most at risk for severe COVID-19, and some can shed the SARS-CoV-2 virus for extended periods, ranging from weeks to 9 months.
  • A study involving 29 patients with persistent viral shedding and 40 controls identified fever and low lymphocyte counts as significant risk factors, alongside the finding that unvaccinated individuals have a much higher risk of persistent shedding.
  • Immunocompromised patients who shed the virus persistently are also at increased risk of hospitalization, invasive aspergillosis (a fungal infection), and death, highlighting the need for regular screenings during viral shedding.

Article Abstract

Background: Immunocompromised patients now represent the population most at risk for severe coronavirus disease 2019. Persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral shedding was reported in these patients ranging from several weeks up to 9 months. We conducted a bicentric retrospective case-control study to identify risk and prognostic factors associated with persistent viral shedding in immunocompromised patients.

Material And Methods: Symptomatic immunocompromised adults with persistent SARS-CoV-2 viral shedding >8 weeks were retrospectively included between 1 March 2020 and 24 April 2022 at 2 university hospitals in Paris, France, and matched with a control group consisting of symptomatic immunocompromised patients without persistent viral shedding.

Results: Twenty-nine immunocompromised patients with persistent viral shedding were compared with 40 controls. In multivariate analysis, fever and lymphocytopenia (<0.5 G/L) were associated with an increased risk of persistent viral shedding (odds ratio [OR]: 3.3; 95% confidence interval [CI], 1.01-11.09) = .048 and OR: 4.3; 95% CI, 1.2-14.7; = .019, respectively). Unvaccinated patients had a 6-fold increased risk of persistent viral shedding (OR, 6.6; 95% CI, 1.7-25.1; = .006). Patients with persistent viral shedding were at risk of hospitalization (OR: 4.8; 95 CI, 1.5-15.6; = .008), invasive aspergillosis (OR: 10.17; 95 CI, 1.15-89.8; = .037) and death (log-rank test <0.01).

Conclusions: Vaccine coverage was protective against SARS-CoV-2 persistent viral shedding in immunocompromised patients. This new group of immunocompromised patients with SARS-CoV-2 persistent viral shedding is at risk of developing invasive aspergillosis and death and should therefore be systematically screened for this fungal infection for as long as the viral shedding persists.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10883287PMC
http://dx.doi.org/10.1093/ofid/ofae012DOI Listing

Publication Analysis

Top Keywords

viral shedding
20
immunocompromised patients
16
patients persistent
12
sars-cov-2 viral
12
persistent viral
12
persistent sars-cov-2
8
shedding weeks
8
retrospective case-control
8
case-control study
8
symptomatic immunocompromised
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!