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

Area of Science:

• Infectious Diseases
• Transplant Surgery
• Virology

Background:

• Optimal duration of transmission-based precautions for immunocompromised patients with SARS-CoV-2 remains unclear.
• Immunocompromised individuals, particularly solid organ transplant recipients, may experience prolonged viral shedding.

Purpose of the Study:

• To investigate the duration of viral shedding in solid organ transplant recipients with SARS-CoV-2.
• To assess the potential for prolonged high viral burden in this patient population.

Main Methods:

• Retrospective review of hospitalized solid organ transplant recipients with SARS-CoV-2.
• Analysis of nasopharyngeal polymerase chain reaction (PCR) results and cycle threshold (Ct) values.

Main Results:

• Twenty-one percent of recipients showed SARS-CoV-2 PCR positivity at or after 20 days post-symptom onset or first positive test.
• A low cycle threshold (indicating high viral load) was detected in these patients, most of whom were asymptomatic or improving.

Conclusions:

• Solid organ transplant recipients may exhibit prolonged SARS-CoV-2 viral burden.
• Further research is needed to determine if cycle threshold data can guide transmission precautions and discontinuation strategies.