Eur J Haematol
. 2023 Mar 25.
doi: 10.1111/ejh.13967. Online ahead of print.
Trajectories of the SARS-CoV-2 RNA load in patients with haematological malignancy
Satoshi Mitsuyuki 1 , Masashi Nishikubo 1 , Yoshimitsu Shimomura 1 2 , Yukie Ohyama 3 , Hayato Maruoka 3 , Seiko Nasu 3 , Tomoyo Kubo 1 , Yuta Suzuki 1 , Naoki Okada 1 , Daishi Nakagawa 1 , Kimimori Kamijo 1 , Ryusuke Yamamoto 1 , Yuya Nagai 1 , Nobuhiro Hiramoto 1 , Satoshi Yoshioka 1 , Noboru Yonetani 1 , Kohei Hasegawa 4 , Hirokazu Kuroda 4 , Toshikazu Hasuike 4 , Asako Doi 4 , Tadakazu Kondo 1 , Takayuki Ishikawa 1
Affiliations
- PMID: 36965014
- DOI: 10.1111/ejh.13967
Abstract
Objectives: The higher risk of prolonged viral shedding in coronavirus disease (COVID-19) patients with haematological malignancies (HM) necessitates test-based de-isolation strategies. However, evidence to establish their appropriate isolation period is insufficient. This study investigated the factors affecting prolonged viral shedding and the requisite isolation period in these patients.
Methods: We retrospectively reviewed 14 COVID-19 patients with HM between January and April 2022, who were subjected to our test-based de-isolation strategy, followed by analysis of the viral load trajectory. The viral loads of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were evaluated using the cycle threshold (Ct) of the reverse-transcription quantitative polymerase chain reaction. The trajectories were classified according to the time-interval from COVID-19 onset to attainment of Ct values >30.
Results: The median interval between onset and attainment of a Ct value >30 was 22 days. Five patients with mild or moderate COVID-19 without intense treatment histories achieved Ct values >30 within 20 days. The other nine patients needed more than 20 days, including three patients who did not meet this criterion during the observation period.
Conclusions: The SARS-CoV-2 viral load trajectories in patients with HM can be stratified by treatment history for the underlying HM and severity of COVID-19. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; SARS-CoV-2; Virus Shedding.