Duration of infectious virus shedding of SARS-CoV-2 Omicron variant among immunocompromised patients

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2025-01-21 DOI:10.1016/j.jiac.2025.102631

Kohei Kamegai , Naoya Itoh , Masahiro Ishikane , Noriko Iwamoto , Yusuke Asai , Nana Akazawa-Kai , Noriko Fuwa , Jin Takasaki , Masayuki Hojo , Akira Hangaishi , Tomiteru Togano , Katsuji Teruya , Kenichiro Takahashi , Sho Miyamoto , Yuichiro Hirata , Takayuki Kanno , Tomoya Saito , Harutaka Katano , Tadaki Suzuki , Norio Ohmagari

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引用次数: 0

Abstract

Objective

The duration of viral shedding and criteria for de-isolation in the hospital among immunocompromised patients with coronavirus disease 2019 (COVID-19) remain unclear. This study aimed to evaluate viral shedding duration in immunocompromised patients infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2.

Methods

A prospective cohort study was performed at 2 tertiary medical centers in Japan during the Omicron epidemic waves from July 2022 to January 2023. Nasopharyngeal swabs were serially collected from immunocompromised patients with COVID-19, including those with hematological malignancies, solid tumors, autoimmune diseases, and human immunodeficiency virus infection. Patients were classified as severely or moderately immunocompromised according to the Japanese national guidelines for tixagevimab-cilgavimab. The relationship between patient characteristics, immune status, duration of viral RNA presence, and infectious virus shedding were assessed using Mann–Whitney U and Fisher's exact tests.

Results

Among 41 patients (163 samples), 9 (47 samples) were severely and 32 (116 samples) were moderately immunocompromised. In the severely and moderately immunocompromised groups, 87.2 % and 75.0 % of the samples were viral RNA-positive, while 36.2 % and 35.3 % were culture-positive, respectively. Five culture-positive samples after day 20 were from 2 severely immunocompromised patients on B cell depletion therapy. No culture-positive samples were found for the moderately immunocompromised patients after day 10.

Conclusions

Long-term viral shedding should be closely monitored in severely immunocompromised patients with COVID-19.

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来源期刊

Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

4.10

自引率

4.50%

发文量

303

审稿时长

47 days

期刊介绍： The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.