Related Experiment Video
Updated: Jul 2, 2025
Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
Increased Risk of Invasive Aspergillosis in Immunocompromised Patients With Persistent SARS-CoV-2 Viral Shedding >8
Cléa Melenotte1, Nathalie Chavarot2,3,4, Anne-Sophie L'Honneur3,5
1Department of Infectious Diseases and Tropical Medicine, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.
Background:
Immunocompromised patients now represent the population most at risk for severe coronavirus disease 2019. Persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral shedding was reported in these patients ranging from several weeks up to 9 months. We conducted a bicentric retrospective case-control study to identify risk and prognostic factors associated with persistent viral shedding in immunocompromised patients.
Material And Methods:
Symptomatic immunocompromised adults with persistent SARS-CoV-2 viral shedding >8 weeks were retrospectively included between 1 March 2020 and 24 April 2022 at 2 university hospitals in Paris, France, and matched with a control group consisting of symptomatic immunocompromised patients without persistent viral shedding.
Results:
Twenty-nine immunocompromised patients with persistent viral shedding were compared with 40 controls. In multivariate analysis, fever and lymphocytopenia (<0.5 G/L) were associated with an increased risk of persistent viral shedding (odds ratio [OR]: 3.3; 95% confidence interval [CI], 1.01-11.09) P = .048 and OR: 4.3; 95% CI, 1.2-14.7; P = .019, respectively). Unvaccinated patients had a 6-fold increased risk of persistent viral shedding (OR, 6.6; 95% CI, 1.7-25.1; P = .006). Patients with persistent viral shedding were at risk of hospitalization (OR: 4.8; 95 CI, 1.5-15.6; P = .008), invasive aspergillosis (OR: 10.17; 95 CI, 1.15-89.8; P = .037) and death (log-rank test <0.01).
Conclusions:
Vaccine coverage was protective against SARS-CoV-2 persistent viral shedding in immunocompromised patients. This new group of immunocompromised patients with SARS-CoV-2 persistent viral shedding is at risk of developing invasive aspergillosis and death and should therefore be systematically screened for this fungal infection for as long as the viral shedding persists.
Insights
Immunocompromised patients with persistent SARS-CoV-2 viral shedding face increased risks of hospitalization, invasive aspergillosis, and death. Vaccination significantly reduces this risk, highlighting its importance in managing severe coronavirus disease 2019 in vulnerable populations.
Area of Science:
- Infectious Diseases
- Immunology
- Critical Care Medicine
Background:
- Immunocompromised individuals are highly susceptible to severe coronavirus disease 2019 (COVID-19).
- Persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral shedding can last for months in these patients.
- Identifying risk and prognostic factors for prolonged viral shedding is crucial for patient management.
Purpose of the Study:
- To identify risk factors associated with persistent SARS-CoV-2 viral shedding in immunocompromised patients.
- To determine prognostic factors and outcomes for immunocompromised patients experiencing persistent viral shedding.
- To evaluate the impact of vaccination on persistent SARS-CoV-2 viral shedding.
Main Methods:
- A bicentric retrospective case-control study was conducted.
- Symptomatic immunocompromised adults with SARS-CoV-2 viral shedding >8 weeks were included.
- Patients were matched with a control group of immunocompromised individuals without persistent viral shedding.
Main Results:
- Fever and lymphocytopenia (<0.5 G/L) were linked to increased risk of persistent viral shedding.
- Unvaccinated patients had a significantly higher risk (OR: 6.6) of persistent viral shedding.
- Persistent viral shedding correlated with higher risks of hospitalization (OR: 4.8), invasive aspergillosis (OR: 10.17), and death.
Conclusions:
- Vaccine coverage is protective against SARS-CoV-2 persistent viral shedding in immunocompromised patients.
- Patients with persistent shedding are at elevated risk for invasive aspergillosis and mortality.
- Systematic screening for invasive fungal infections is recommended for immunocompromised patients with ongoing viral shedding.
More Related Videos
08:01Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
15:01Confocal Laser Scanning Microscopy-Based Quantitative Analysis of Aspergillus fumigatus Conidia Distribution in Whole-Mount Optically Cleared Mouse Lung
Published on: September 18, 2021
Related Concept Videos
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:28Pulmonary Tuberculosis II
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:03Rous Sarcoma Virus (RSV) and Cancer
RSV is a retrovirus that contains two copies of a plus-strand RNA genome. Its genome consists of four main open...