Publication date: Jan 21, 2025

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

Semantics

Original Article