Tweet
J Infect Chemother
. 2025 Jan 21:102631.
doi: 10.1016/j.jiac.2025.102631. Online ahead of print. Duration of infectious virus shedding of SARS-CoV-2 Omicron variant among immunocompromised patients
Kohei Kamegai 1 , Naoya Itoh 2 , Masahiro Ishikane 3 , Noriko Iwamoto 1 , Yusuke Asai 1 , Nana Akazawa-Kai 4 , Noriko Fuwa 1 , Jin Takasaki 5 , Masayuki Hojo 5 , Akira Hangaishi 6 , Tomiteru Togano 7 , Katsuji Teruya 8 , Kenichiro Takahashi 9 , Sho Miyamoto 10 , Yuichiro Hirata 10 , Takayuki Kanno 10 , Tomoya Saito 9 , Harutaka Katano 10 , Tadaki Suzuki 11 , Norio Ohmagari 1
Affiliations
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.
Keywords: De-isolation; Immunocompromised; Infectivity; SARS-CoV-2.
. 2025 Jan 21:102631.
doi: 10.1016/j.jiac.2025.102631. Online ahead of print. Duration of infectious virus shedding of SARS-CoV-2 Omicron variant among immunocompromised patients
Kohei Kamegai 1 , Naoya Itoh 2 , Masahiro Ishikane 3 , Noriko Iwamoto 1 , Yusuke Asai 1 , Nana Akazawa-Kai 4 , Noriko Fuwa 1 , Jin Takasaki 5 , Masayuki Hojo 5 , Akira Hangaishi 6 , Tomiteru Togano 7 , Katsuji Teruya 8 , Kenichiro Takahashi 9 , Sho Miyamoto 10 , Yuichiro Hirata 10 , Takayuki Kanno 10 , Tomoya Saito 9 , Harutaka Katano 10 , Tadaki Suzuki 11 , Norio Ohmagari 1
Affiliations
- PMID: 39848541
- DOI: 10.1016/j.jiac.2025.102631
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.
Keywords: De-isolation; Immunocompromised; Infectivity; SARS-CoV-2.