Cycle Thresholds Among Solid Organ Transplant Recipients Testing Positive for SARS-CoV-2

Transplantation. 2021 Jul 1;105(7):1445-1448. doi: 10.1097/TP.0000000000003695.

Abstract

Background: The optimal duration of transmission-based precautions among immunocompromised patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unknown.

Methods: Retrospective review of patients with solid organ transplant with positive SARS-CoV-2 polymerase chain reaction result from nasopharyngeal specimens admitted to the hospital between March 13, 2020 and May 15, 2020.

Results: Twenty-one percent of solid organ transplant recipients with positive SARS-CoV-2 polymerase chain reaction detected ≥20 d after symptom onset (or after first positive test among asymptomatic individuals) had a low cycle threshold (ie, high viral load). The majority of these patients were asymptomatic or symptomatically improved.

Conclusions: Solid organ transplant recipients may have prolonged high viral burden of SARS-CoV-2. Further data are needed to understand whether cycle threshold data can help inform strategies for prevention of healthcare-associated transmission of SARS-CoV-2 and for appropriate discontinuation of transmission-based precautions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Asymptomatic Infections
  • COVID-19 / diagnosis
  • COVID-19 / prevention & control
  • COVID-19 / transmission
  • COVID-19 / virology*
  • COVID-19 Testing*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Organ Transplantation*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / prevention & control
  • Postoperative Complications / virology*
  • Retrospective Studies
  • Viral Load*