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Case Reports
. 2021 May 20;223(9):1522-1527.
doi: 10.1093/infdis/jiab075.

Long-Term Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectiousness Among Three Immunocompromised Patients: From Prolonged Viral Shedding to SARS-CoV-2 Superinfection

Hassan Tarhini  1 , Amélie Recoing  2   3 , Antoine Bridier-Nahmias  3 , Mayda Rahi  1 , Céleste Lambert  4 , Pascale Martres  5 , Jean-Christophe Lucet  3   6 , Christophe Rioux  1 , Donia Bouzid  3   7 , Samuel Lebourgeois  2   3 , Diane Descamps  2   3 , Yazdan Yazdanpanah  1   3 , Quentin Le Hingrat  2   3 , François-Xavier Lescure  1   3 , Benoit Visseaux  2   3
Affiliations
Case Reports

Long-Term Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectiousness Among Three Immunocompromised Patients: From Prolonged Viral Shedding to SARS-CoV-2 Superinfection

Hassan Tarhini et al. J Infect Dis. .

Abstract

Background: Guidelines for stopping coronavirus disease 2019 patient isolation are mainly symptom-based, with isolation for 10 to 20 days depending on their condition.

Methods: In this study, we describe 3 deeply immunocompromised patients, each with different clinical evolutions. We observed (1) the patients' epidemiological, clinical, and serological data, (2) infectiousness using viral culture, and (3) viral mutations accumulated over time.

Results: Asymptomatic carriage, symptom resolution, or superinfection with a second severe acute respiratory syndrome coronavirus 2 strain were observed, all leading to prolonged infectious viral shedding for several months.

Conclusions: Understanding underlying mechanisms and frequency of prolonged infectiousness is crucial to adapt current guidelines and strengthen the use of systematic polymerase chain reaction testing before stopping isolation in immunocompromised populations.

Keywords: COVID-19; SARS-CoV-2; immunocompromised patients; isolation; viral shedding.

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