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Persistence of live virus in critically ill patients infected with SARS-COV-2: a prospective observational study.
Funk, Duane J; Bullard, Jared; Lother, Sylvan; Grande, Gloria Vazquez; Garnett, Lauren; Doan, Kaylie; Dust, Kerry; Kumar, Anand; Poliquin, Guillaume; Strong, Jim.
Afiliación
  • Funk DJ; Departments of Anesthesiology and Medicine, Section of Critical Care, Max Rady College of Medicine, University of Manitoba, 2nd Floor Harry Medovy House, 671 William Avenue, Winnipeg, MB, R3E 0Z2, Canada. Duane.Funk@Umanitoba.ca.
  • Bullard J; National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada. Duane.Funk@Umanitoba.ca.
  • Lother S; Cadham Provincial Laboratory, Manitoba Health, Winnipeg, MB, Canada.
  • Grande GV; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.
  • Garnett L; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada.
  • Doan K; Department of Medicine, Sections of Infectious Disease and Critical Care, University of Manitoba, Winnipeg, MB, Canada.
  • Dust K; Department of Medicine, Sections of Infectious Disease and Critical Care, University of Manitoba, Winnipeg, MB, Canada.
  • Kumar A; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada.
  • Poliquin G; National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
  • Strong J; National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
Crit Care ; 26(1): 10, 2022 01 04.
Article en En | MEDLINE | ID: mdl-34983614
BACKGROUND: Research on the duration of infectivity of ICU patients with COVID-19 has been sparse. Tests based on Reverse Transcriptase polymerase chain reaction (RT-PCR) detect both live virus and non-infectious viral RNA. We aimed to determine the duration of infectiousness based on viral culture of nasopharyngeal samples of patients with COVID-19. METHODS: Prospective observational study in adult intensive care units with a diagnosis of COVID-19 Pneumonia. Patients had repeated nasopharyngeal sampling performed after day 10 of ICU admission. Culture positive rate (based on viral culture on Vero cells in a level 4 lab) and Cycle threshold from RT-PCR were measured. RESULTS: Nine patients of the 108 samples (8.3%, 95% CI 3.9-15.2%) grew live virus at a median of 13 days (interquartile range 11-19) after their initial positive test. 74.1% of patients were RT-PCR positive but culture negative, and the remaining (17.6%) were RT-PCR and culture negative. Cycle threshold showed excellent ability to predict the presence of live virus, with a Ct < 25 with an AUC of 0.90 (95% CI 0.83-0.97, p < 0.001). The specificity of a Ct > 25 to predict negative viral culture was 100% (95% CI 70-100%). CONCLUSION: 8.3% of our ICU patients with COVID-19 grew live virus at a median of 13 days post-initial positive RT-PCR test. Severity of illness, use of mechanical ventilation, and time between tests did not predict the presence of live virus. Cycle threshold of > 25 had the best ability to determine the lack of live virus in these patents.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: SARS-CoV-2 / COVID-19 Tipo de estudio: Observational_studies Límite: Adult / Humans Idioma: En Revista: Crit Care Año: 2022 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: SARS-CoV-2 / COVID-19 Tipo de estudio: Observational_studies Límite: Adult / Humans Idioma: En Revista: Crit Care Año: 2022 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido