Increased Risk of Invasive Aspergillosis in Immunocompromised Patients With Persistent SARS-CoV-2 Viral Shedding >8 Weeks, Retrospective Case-control Study.

COVID-19 SARS-CoV-2 death hematological diseases immunocompromised host invasive aspergillosis persistent viral shedding solid organ transplant recipients

Journal

Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045

Informations de publication

Date de publication:
Feb 2024
Historique:
received: 04 12 2023
accepted: 07 01 2024
medline: 23 2 2024
pubmed: 23 2 2024
entrez: 23 2 2024
Statut: epublish

Résumé

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. 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. 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) 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.

Sections du résumé

Background UNASSIGNED
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 UNASSIGNED
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 UNASSIGNED
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)
Conclusions UNASSIGNED
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.

Identifiants

DOI: 10.1093/ofid/ofae012 PMID: 38390457 PMC: PMC10883287
pubmed: 38390457
doi: 10.1093/ofid/ofae012
pii: ofae012
pmc: PMC10883287
doi:

Types de publication

Journal Article

Langues

eng

Pagination

ofae012

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Auteurs

Cléa Melenotte (C)

Department of Infectious Diseases and Tropical Medicine, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.
ORCID: 0000-0003-3159-1061

Nathalie Chavarot (N)

Department of Nephrology and Kidney Transplantation, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.
Paris-Cité University, Paris, France.
Department of Nephrology and Kidney Transplantation, European Hospital Georges Pompidou, Public Assistance of the Hospital of Paris, Paris, France.

Anne-Sophie L'Honneur (AS)

Paris-Cité University, Paris, France.
Department of Virology, Cochin University Hospital, Public Assistance of the Hospital of Paris, Paris, France.

Sylvain Bodard (S)

Paris-Cité University, Paris, France.
Department of Imaging, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.

Morgane Cheminant (M)

Paris-Cité University, Paris, France.
Department of Hematology, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.

Adrien Flahault (A)

Department of Nephrology and Kidney Transplantation, European Hospital Georges Pompidou, Public Assistance of the Hospital of Paris, Paris, France.

Yann Nguyen (Y)

Department of Internal Medicine, University Hospital Cochin, Public Assistance of the Hospital of Paris, Paris, France.
ORCID: 0000-0002-0866-3824

Marianne Burgard (M)

Department of Virology, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.

Eric Dannaoui (E)

Paris-Cité University, Paris, France.
Department of Mycology and Parasitology, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.

Marie-Elisabeth Bougnoux (ME)

Paris-Cité University, Paris, France.
Department of Mycology and Parasitology, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.
ORCID: 0000-0003-4721-2740

Perrine Parize (P)

Department of Infectious Diseases and Tropical Medicine, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.
ORCID: 0000-0002-0786-7518

Claire Rouzaud (C)

Department of Infectious Diseases and Tropical Medicine, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.

Anne Scemla (A)

Department of Nephrology and Kidney Transplantation, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.

Etienne Canouï (E)

Mobile Team of Infectious Diseases and Tropical Medicine, Cochin University Hospital, Public Assistance of the Hospital of Paris, France.
ORCID: 0000-0003-0612-5691

Emmanuel Lafont (E)

Department of Internal Medicine, European Hospital Georges Pompidou, Public Assistance of the Hospital of Paris, Paris, France.

Damien Vimpere (D)

Department of Intensive Care Unit, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.

Julien Zuber (J)

Department of Nephrology and Kidney Transplantation, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.
Paris-Cité University, Paris, France.

Caroline Charlier (C)

Paris-Cité University, Paris, France.
Mobile Team of Infectious Diseases and Tropical Medicine, Cochin University Hospital, Public Assistance of the Hospital of Paris, France.
ORCID: 0000-0002-9375-3620

Felipe Suarez (F)

Paris-Cité University, Paris, France.
Department of Hematology, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.

Dany Anglicheau (D)

Department of Nephrology and Kidney Transplantation, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.
Paris-Cité University, Paris, France.

Olivier Hermine (O)

Paris-Cité University, Paris, France.
Department of Hematology, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.

Fanny Lanternier (F)

Department of Infectious Diseases and Tropical Medicine, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.
Paris-Cité University, Paris, France.

Luc Mouthon (L)

Paris-Cité University, Paris, France.
Department of Internal Medicine, University Hospital Cochin, Public Assistance of the Hospital of Paris, Paris, France.

Olivier Lortholary (O)

Department of Infectious Diseases and Tropical Medicine, Hospital Necker-Enfants Malades, Public Assistance of the Hospital of Paris, Paris, France.
Paris-Cité University, Paris, France.
Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasives Mycoses and Antifungals, Mycology Translational Research Group, Paris, France.

Classifications MeSH