Han Alice, Rodriguez Tulio E, Beck Eric T, Relich Ryan F, Udeoji Dioma U, Petrak Robert, Chundi Vishnu V
Metro Infectious Disease Consultants, 901 McClintock Drive, Suite 201, Burr Ridge, Chicago, IL 60527, United States.
Department of Medicine, Advocate Lutheran General Hospital, Advocate Aurora Health, Rosalind Franklin University of Medicine and Science, North Chicago, United States.
Curr Probl Cancer Case Rep. 2021 Mar;3:100057. doi: 10.1016/j.cpccr.2021.100057. Epub 2021 Jan 16.
The coronavirus disease 19 (COVID-19) pandemic has infected tens of millions across the world, but there is a significant gap in our understanding about COVID-19 in the hematopoietic stem transplant (HSCT) recipient population. Prolonged viral shedding is frequently observed with severe acute respiratory syndrome coronavirus-2 (SARSCoV-2), but studies suggest viral loads decline 10 days after symptom onset. Current CDC guidance suggests that severely ill and immunocompromised hosts are no longer infectious after 20 days from symptom onset. Cycle threshold (Ct) values are inversely proportional to the viral load and are used to detect SARS-CoV-2 RNA concentration. Specimens with reverse transcriptase PCR (RT-PCR) Ct values > 33-34 have been associated with inability to culture virus, and have been used as a surrogate for diminished infectivity. We report two cases of allogeneic peripheral blood stem cell transplant (PBSCT) recipients who had prolonged durations of infectivity with SARSCov-2, based on culture positivity and persistently low Ct values for greater than 50 days.
新型冠状病毒肺炎（COVID-19）大流行已在全球感染了数千万人，但我们对造血干细胞移植（HSCT）受者群体中COVID-19的了解存在重大差距。严重急性呼吸综合征冠状病毒2（SARS-CoV-2）经常出现病毒长时间脱落的情况，但研究表明，症状出现10天后病毒载量会下降。美国疾病控制与预防中心（CDC）目前的指导意见表明，重症和免疫功能低下的宿主在症状出现20天后不再具有传染性。循环阈值（Ct）值与病毒载量成反比，用于检测SARS-CoV-2 RNA浓度。逆转录聚合酶链反应（RT-PCR）Ct值>33-34的样本与无法培养出病毒有关，并已被用作传染性降低的替代指标。我们报告了两例异基因外周血干细胞移植（PBSCT）受者，基于培养阳性和持续50多天的低Ct值，他们感染SARS-CoV-2的时间延长。
