Low risk of prolonged SARS-CoV-2 shedding and molecular evolution in kidney transplant recipients during the Omicron era: A prospective observational study
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, pozorovací studie
PubMed
39638044
DOI
10.1016/j.ajt.2024.11.031
PII: S1600-6135(24)00744-5
Knihovny.cz E-zdroje
- Klíčová slova
- SARS-CoV-2, immunodeficiency, immunosuppression, infectiousness, kidney transplantation, public health, virus evolution, virus viability,
- MeSH
- COVID-19 * virologie epidemiologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- molekulární evoluce * MeSH
- mutace MeSH
- příjemce transplantátu * MeSH
- prospektivní studie MeSH
- SARS-CoV-2 * genetika izolace a purifikace fyziologie MeSH
- senioři MeSH
- transplantace ledvin * MeSH
- vylučování virů * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
The aim of this prospective study was to assess the duration of culture-viable SARS-CoV-2 and to monitor the emergence of mutations in a cohort of 23 kidney transplant recipients (KTRs) from June 2022 to June 2023. Combined nares/oropharyngeal swabs were collected weekly starting as soon as possible after symptom onset. The time from symptom onset to a negative culture was 11 days (interquartile range, 8-14), while the time to negative reverse transcriptase quantitative polymerase chain reaction was 18 days (interquartile range, 15-30). Beyond the first swab, 21.7% had a positive culture, and 8.7% replicated viable virus for longer than 30 days. T cell depletion (rate ratio, 2.5; 95% confidence interval [95% CI], 1.9-3.3; P < .001) and time from transplantation (rate ratio, 0.93; 95% CI, 0.90-0.97; P = .006) were associated with the time of viable virus shedding. A cycle threshold value of 24.2 demonstrated a 91.3% negative predictive value of viability (95% credible interval [95% CrI], 76-100). The odds of viability decreased by 69% per week of infection (odds ratio, 0.31; 95% CrI, 0.12-0.76). Overall, ribonucleic acid sequencing did not show accelerated molecular evolution though mutation rate could be increased in molnupiravir-treated KTRs. In conclusion, viable SARS-CoV-2 is eliminated rapidly, the risk of virus evolution is low, and prolonged self-isolation is generally unnecessary for most KTRs.
Department of Data Science Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Immunology Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Nephrology Institute for Clinical and Experimental Medicine Prague Czech Republic
Institute of Molecular Genetics Academy of Sciences of the Czech Republic Prague Czech Republic
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