Prolonged viral shedding of SARS-CoV-2 in an immunocompromised patient

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 27; no. 2; pp. 387 - 389
• Main Authors: Nakajima, Yukiko, Ogai, Asuca, Furukawa, Karin, Arai, Ryosuke, Anan, Ryusuke, Nakano, Yasushi, Kurihara, Yuko, Shimizu, Hideaki, Misaki, Takako, Okabe, Nobuhiko
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2021; Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd
• Subjects: Antiviral Agents - therapeutic use; Bendamustine; Case Report; COVID-19 - complications; COVID-19 - immunology; COVID-19 - therapy; COVID-19 - virology; Follicular lymphoma; Humans; Immunocompromised Host; Immunocompromised state; Lymphoma - complications; Lymphoma - virology; Male; Middle Aged; Nasopharynx - virology; Reverse Transcriptase Polymerase Chain Reaction - methods; RNA, Viral - analysis; SARS-CoV-2 - isolation & purification; SARS-CoV-2 PCR; Time Factors; Treatment Outcome; Viral replication; Virus Shedding; SARS-CoV-2 PCR; Follicular lymphoma; Bendamustine; Viral replication; Immunocompromised state
• ISSN: 1341-321X; 1437-7780; 1437-7780
• DOI: 10.1016/j.jiac.2020.12.001

The duration of viral shedding of SARS-CoV-2 is usually less than 10 days. We experienced a COVID-19 case with prolonged viral shedding for 2 months. His cell mediated immunity has been depressed (CD4+T cell <100/μl) due to advanced malignant lymphoma and chemotherapy which had been completed 4 months prior to the onset of symptoms of COVID-19. We administered several treatments against COVID-19, however the results of Polymerase Chain Reaction (PCR) from nasopharyngeal specimens remained positive to SARS-CoV-2 for 2 months. Moreover, virus isolation assays performed on Day 59 also remained positive. He was finally discharged on Day 69 with two consecutive negative PCR results for SARS-CoV-2. Immunocompromised status may prolong viral shedding and it is therefore important for the clinician to take into account this when assessing such patients.