Details

Autor(en) / Beteiligte

• 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
• Hermine, Olivier
• Lanternier, Fanny
• Mouthon, Luc
• Lortholary, Olivier

Titel

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

Ist Teil von

• Open forum infectious diseases, 2024-02, Vol.11 (2), p.ofae012

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2024

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• 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. Immunocompromised patients are the population most at risk of severe coronavirus disease 2019. Among them, patients with persistent severe acute respiratory syndrome coronavirus 2 viral shedding (>8 weeks) have a 10-fold higher risk of invasive aspergillosis, 4-fold increased risk of hospitalization, and increased risk of death.