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器官移植受者新冠病毒检测阳性的循环阈值。

Cycle Thresholds Among Solid Organ Transplant Recipients Testing Positive for SARS-CoV-2.

机构信息

Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY.

Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY.

出版信息

Transplantation. 2021 Jul 1;105(7):1445-1448. doi: 10.1097/TP.0000000000003695.

Abstract

BACKGROUND

The optimal duration of transmission-based precautions among immunocompromised patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unknown.

METHODS

Retrospective review of patients with solid organ transplant with positive SARS-CoV-2 polymerase chain reaction result from nasopharyngeal specimens admitted to the hospital between March 13, 2020 and May 15, 2020.

RESULTS

Twenty-one percent of solid organ transplant recipients with positive SARS-CoV-2 polymerase chain reaction detected ≥20 d after symptom onset (or after first positive test among asymptomatic individuals) had a low cycle threshold (ie, high viral load). The majority of these patients were asymptomatic or symptomatically improved.

CONCLUSIONS

Solid organ transplant recipients may have prolonged high viral burden of SARS-CoV-2. Further data are needed to understand whether cycle threshold data can help inform strategies for prevention of healthcare-associated transmission of SARS-CoV-2 and for appropriate discontinuation of transmission-based precautions.

摘要

背景

免疫功能低下的严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)患者的基于传播预防措施的最佳持续时间尚不清楚。

方法

回顾性分析 2020 年 3 月 13 日至 2020 年 5 月 15 日期间因鼻咽标本中 SARS-CoV-2 聚合酶链反应阳性结果而住院的实体器官移植患者。

结果

在症状出现后≥20 天(或无症状个体首次阳性检测后)检测到 SARS-CoV-2 聚合酶链反应阳性的 21%的实体器官移植受者具有低循环阈值(即高病毒载量)。这些患者大多无症状或症状改善。

结论

实体器官移植受者可能具有 SARS-CoV-2 的高病毒载量持续时间延长。需要进一步的数据来了解循环阈值数据是否有助于确定预防 SARS-CoV-2 医护相关传播的策略,以及是否适当停止基于传播的预防措施。

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