tetano
Editor, Senior Moderator
J Infect Chemother
. 2021 Sep 10;S1341-321X(21)00255-5.
doi: 10.1016/j.jiac.2021.09.006. Online ahead of print.
Duration of infectious virus shedding in patients with severe coronavirus disease 2019 who required mechanical ventilation
Toshihito Nomura[SUP] 1 [/SUP], Hiroki Kitagawa[SUP] 2 [/SUP], Keitaro Omori[SUP] 2 [/SUP], Norifumi Shigemoto[SUP] 3 [/SUP], Masaki Kakimoto[SUP] 4 [/SUP], Tanuza Nazmul[SUP] 5 [/SUP], Nobuaki Shime[SUP] 6 [/SUP], Takemasa Sakaguchi[SUP] 5 [/SUP], Hiroki Ohge[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Approximately 5% of patients with coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 develop severe COVID-19. Severe COVID-19 requires respiratory management with mechanical ventilation and an extended period of treatment. Prolonged infectious virus shedding is a concern in severe COVID-19 cases, but few reports have examined the duration of infectious virus shedding. Therefore, we investigated the duration of infectious virus shedding in patients transferred to Hiroshima University Hospital with severe COVID-19 requiring mechanical ventilation.
Methods: Nasopharyngeal swab specimens were collected and analyzed using both viral culture and reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) tests between December 2020 and February 2021.
Results: Of the 23 patients tested, the proportions of those with positive test results at first specimen collection (the median number of days to first specimen collection after symptom onset was 10) on RT-qPCR and viral culture tests were 95·7% and 30·4%, respectively. All six patients with positive viral culture test results who were followed-up tested negative 24 days after symptom onset but remained positive on RT-qPCR. Viral loads based on PCR testing did not decrease over time, but those determined via culture tests decreased over time. The longest negative conversion time was observed in a dialysis patient on immunosuppressive drugs.
Conclusions: This study indicated that patients with severe COVID-19 remain culture positive for ≥ 10 days after symptom onset. Additionally, immunosuppressed patients with severe COVID-19 could consider isolation for ≥ 20 days.
Keywords: SARS-CoV-2; Severe coronavirus disease; Virus shedding.
. 2021 Sep 10;S1341-321X(21)00255-5.
doi: 10.1016/j.jiac.2021.09.006. Online ahead of print.
Duration of infectious virus shedding in patients with severe coronavirus disease 2019 who required mechanical ventilation
Toshihito Nomura[SUP] 1 [/SUP], Hiroki Kitagawa[SUP] 2 [/SUP], Keitaro Omori[SUP] 2 [/SUP], Norifumi Shigemoto[SUP] 3 [/SUP], Masaki Kakimoto[SUP] 4 [/SUP], Tanuza Nazmul[SUP] 5 [/SUP], Nobuaki Shime[SUP] 6 [/SUP], Takemasa Sakaguchi[SUP] 5 [/SUP], Hiroki Ohge[SUP] 2 [/SUP]
Affiliations
- PMID: 34538728
- DOI: 10.1016/j.jiac.2021.09.006
Abstract
Background: Approximately 5% of patients with coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 develop severe COVID-19. Severe COVID-19 requires respiratory management with mechanical ventilation and an extended period of treatment. Prolonged infectious virus shedding is a concern in severe COVID-19 cases, but few reports have examined the duration of infectious virus shedding. Therefore, we investigated the duration of infectious virus shedding in patients transferred to Hiroshima University Hospital with severe COVID-19 requiring mechanical ventilation.
Methods: Nasopharyngeal swab specimens were collected and analyzed using both viral culture and reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) tests between December 2020 and February 2021.
Results: Of the 23 patients tested, the proportions of those with positive test results at first specimen collection (the median number of days to first specimen collection after symptom onset was 10) on RT-qPCR and viral culture tests were 95·7% and 30·4%, respectively. All six patients with positive viral culture test results who were followed-up tested negative 24 days after symptom onset but remained positive on RT-qPCR. Viral loads based on PCR testing did not decrease over time, but those determined via culture tests decreased over time. The longest negative conversion time was observed in a dialysis patient on immunosuppressive drugs.
Conclusions: This study indicated that patients with severe COVID-19 remain culture positive for ≥ 10 days after symptom onset. Additionally, immunosuppressed patients with severe COVID-19 could consider isolation for ≥ 20 days.
Keywords: SARS-CoV-2; Severe coronavirus disease; Virus shedding.