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

Authors :
Melenotte, Cléa
Chavarot, Nathalie
L'Honneur, Anne-Sophie
Bodard, Sylvain
Cheminant, Morgane
Flahault, Adrien
Nguyen, Yann
Burgard, Marianne
Dannaoui, Eric
Bougnoux, Marie-Elisabeth
Parize, Perrine
Rouzaud, Claire
Scemla, Anne
Canouï, Etienne
Lafont, Emmanuel
Vimpere, Damien
Zuber, Julien
Charlier, Caroline
Suarez, Felipe
Anglicheau, Dany
Source :
Open Forum Infectious Diseases; Feb2024, Vol. 11 Issue 2, p1-10, 10p
Publication Year :
2024

Abstract

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. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
23288957
Volume :
11
Issue :
2
Database :
Complementary Index
Journal :
Open Forum Infectious Diseases
Publication Type :
Academic Journal
Accession number :
176104148
Full Text :
https://doi.org/10.1093/ofid/ofae012