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Longitudinal Assessment of Solid Organ Transplant Recipients With SARS-CoV-2 Infection
Will Vuyk1, Max Bobholz1, Isla Emmen1
1Department of Pathology and Laboratory Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
Transplantation Proceedings
|May 7, 2025
Summary
Forty percent of solid organ transplant recipients shed SARS-CoV-2 RNA for 28 days or longer, indicating prolonged viral shedding in immunocompromised individuals. This persistent SARS-CoV-2 infection raises concerns about potential variant selection.
Area of Science:
- Virology
- Immunology
- Transplant Medicine
Background:
- Individuals who are immunocompromised, such as solid organ transplant (SOT) recipients, face increased risks of severe outcomes from SARS-CoV-2 infection.
- Understanding viral persistence is crucial for managing SARS-CoV-2 in SOT recipients.
Purpose of the Study:
- To determine the duration of SARS-CoV-2 RNA positivity in SOT recipients.
- To evaluate viral persistence in this vulnerable population.
Main Methods:
- Prospective study of SOT recipients with recent SARS-CoV-2 infection.
- Tracking of viral RNA shedding in nasal swabs and stool samples.
- Definition of persistent infection as SARS-CoV-2 RNA detection at ≥28 days post-infection.
Main Results:
- 12 out of 30 (40%) SOT recipients showed SARS-CoV-2 RNA positivity at ≥28 days post-infection.
- One participant had detectable viral RNA for 54 days.
- Three participants tested positive beyond 50 days post-infection.
Conclusions:
- A significant proportion of SOT recipients experience prolonged SARS-CoV-2 RNA shedding.
- Persistent viral detection, even with treatments, highlights immune suppression challenges.
- Concerns exist regarding the potential selection of novel viral variants due to prolonged shedding in immunocompromised hosts.
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