Prolonged viral shedding of SARS-CoV-2 in two immunocompromised patients, a case report
Abstract Background The duration of viable Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) shedding in immunocompromised patients is still unknown. This case report describes the duration of viable SARS-CoV-2 in two immunocompromised patients with completely different clinical courses a...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-021-06429-5 |
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| author | Melissa Niyonkuru Rune Micha Pedersen Kristian Assing Thomas Emil Andersen Marianne Nielsine Skov Isik Somuncu Johansen Lone Wulff Madsen |
| author_facet | Melissa Niyonkuru Rune Micha Pedersen Kristian Assing Thomas Emil Andersen Marianne Nielsine Skov Isik Somuncu Johansen Lone Wulff Madsen |
| author_sort | Melissa Niyonkuru |
| collection | DOAJ |
| description | Abstract Background The duration of viable Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) shedding in immunocompromised patients is still unknown. This case report describes the duration of viable SARS-CoV-2 in two immunocompromised patients with completely different clinical courses and further addresses the immunological aspects. Case presentations Oropharyngeal swaps were collected continuously during hospitalization for two immunocompromised patients infected with SARS-CoV-2 and sent for analysis to real time reverse transcription polymerase chain reaction (RT-PCR), viral culture assessed by plaque assay and full genome sequencing. Blood samples for flow cytometry and further immunological analysis were taken once during admission. One patient was without symptoms of Coronavirus disease 2019 (COVID-19) whereas the other had severe respiratory symptoms requiring a stay at an intensive care unit (ICU) and treatment with remdesivir and dexamethasone. Despite their difference in clinical courses, they both continuously shed SARS-CoV-2 with high viral loads in culture. Both patients had undetectable anti SARS-CoV-2 IgG levels about 2 weeks after the first positive real time RT-PCR test of SARS-CoV-2, marked expansions of virus reactive CD8+ T cells but cellular markers indicative of attenuated humoral immunity. Conclusions Our case illustrates the importance of distinguishing isolation guidelines for patients infected with SARS-CoV-2 according to their immunological status. Furthermore, it demonstrates the need for immune markers relating to viral shedding in immunocompromised patients. |
| first_indexed | 2024-12-17T22:41:20Z |
| format | Article |
| id | doaj.art-f61fcf7ef36c453c869c6bf046f10576 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-17T22:41:20Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-f61fcf7ef36c453c869c6bf046f105762022-12-21T21:29:56ZengBMCBMC Infectious Diseases1471-23342021-08-012111510.1186/s12879-021-06429-5Prolonged viral shedding of SARS-CoV-2 in two immunocompromised patients, a case reportMelissa Niyonkuru0Rune Micha Pedersen1Kristian Assing2Thomas Emil Andersen3Marianne Nielsine Skov4Isik Somuncu Johansen5Lone Wulff Madsen6Department of Infectious Diseases, Odense University HospitalDepartment of Clinical Microbiology, Odense University HospitalDepartment of Clinical Immunology, Odense University HospitalDepartment of Clinical Microbiology, Odense University HospitalDepartment of Clinical Microbiology, Odense University HospitalDepartment of Infectious Diseases, Odense University HospitalDepartment of Infectious Diseases, Odense University HospitalAbstract Background The duration of viable Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) shedding in immunocompromised patients is still unknown. This case report describes the duration of viable SARS-CoV-2 in two immunocompromised patients with completely different clinical courses and further addresses the immunological aspects. Case presentations Oropharyngeal swaps were collected continuously during hospitalization for two immunocompromised patients infected with SARS-CoV-2 and sent for analysis to real time reverse transcription polymerase chain reaction (RT-PCR), viral culture assessed by plaque assay and full genome sequencing. Blood samples for flow cytometry and further immunological analysis were taken once during admission. One patient was without symptoms of Coronavirus disease 2019 (COVID-19) whereas the other had severe respiratory symptoms requiring a stay at an intensive care unit (ICU) and treatment with remdesivir and dexamethasone. Despite their difference in clinical courses, they both continuously shed SARS-CoV-2 with high viral loads in culture. Both patients had undetectable anti SARS-CoV-2 IgG levels about 2 weeks after the first positive real time RT-PCR test of SARS-CoV-2, marked expansions of virus reactive CD8+ T cells but cellular markers indicative of attenuated humoral immunity. Conclusions Our case illustrates the importance of distinguishing isolation guidelines for patients infected with SARS-CoV-2 according to their immunological status. Furthermore, it demonstrates the need for immune markers relating to viral shedding in immunocompromised patients.https://doi.org/10.1186/s12879-021-06429-5SARS-CoV-2Immunocompromised hostVirus sheddingCOVID-19 |
| spellingShingle | Melissa Niyonkuru Rune Micha Pedersen Kristian Assing Thomas Emil Andersen Marianne Nielsine Skov Isik Somuncu Johansen Lone Wulff Madsen Prolonged viral shedding of SARS-CoV-2 in two immunocompromised patients, a case report BMC Infectious Diseases SARS-CoV-2 Immunocompromised host Virus shedding COVID-19 |
| title | Prolonged viral shedding of SARS-CoV-2 in two immunocompromised patients, a case report |
| title_full | Prolonged viral shedding of SARS-CoV-2 in two immunocompromised patients, a case report |
| title_fullStr | Prolonged viral shedding of SARS-CoV-2 in two immunocompromised patients, a case report |
| title_full_unstemmed | Prolonged viral shedding of SARS-CoV-2 in two immunocompromised patients, a case report |
| title_short | Prolonged viral shedding of SARS-CoV-2 in two immunocompromised patients, a case report |
| title_sort | prolonged viral shedding of sars cov 2 in two immunocompromised patients a case report |
| topic | SARS-CoV-2 Immunocompromised host Virus shedding COVID-19 |
| url | https://doi.org/10.1186/s12879-021-06429-5 |
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