Prolonged SARS-CoV-2 viral shedding in patients with chronic kidney disease

O’Sullivan, E. D., Lees, J. S. , Howie, K. L., Pugh, D., Gillis, K. A. , Traynor, J. P., Macintyre, I. and Mark, P. B. (2021) Prolonged SARS-CoV-2 viral shedding in patients with chronic kidney disease. Nephrology, 26(4), pp. 328-332. (doi: 10.1111/nep.13844) (PMID:33368892)

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Abstract

Recent World Health Organization guidance has aimed to provide pragmatic guidance acknowledging the role of sequential nasopharyngeal swabs taken >24 hours apart for SARS‐CoV‐2 in high‐risk populations. Patients with chronic kidney disease (CKD) are known to have an altered immune milieu which may be associated with a delay in viral clearance. Here, a cross‐sectional observational study of 138 patients admitted with SARS‐CoV‐2 infection at two large regional hospitals in Scotland, UK examined the median time to two consecutive negative nasopharyngeal swabs for SARS‐CoV‐2 in an inpatient population. The median time from admission to the first of two consecutive negative nasopharyngeal swabs was 18 days (range = 1‐44) in patients with CKD, compared with 11 days (range: 1‐71) in patients without CKD (P = .0007). Multivariable linear regression analysis using explanatory variables of age, sex, SARS‐CoV‐2 disease severity, key comorbidities and renal function showed that declining estimated glomerular filtration rate was independently associated with prolonged time to viral clearance. Our data suggest that patients with CKD who are admitted to hospital with SARS‐CoV‐2 take longer to achieve sequential negative nasopharyngeal swab reverse transcription‐polymerase chain reaction results than those without CKD. This has implications for renal service provision, discharge planning and hospital capacity as well as a direct impact on patients due to extended hospital stay, anxiety and stigmatisation.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gillis, Dr Keith and Mark, Professor Patrick and Lees, Jennifer and Traynor, Dr Jamie
Authors: O’Sullivan, E. D., Lees, J. S., Howie, K. L., Pugh, D., Gillis, K. A., Traynor, J. P., Macintyre, I., and Mark, P. B.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Nephrology
Publisher:Wiley
ISSN:1320-5358
ISSN (Online):1440-1797
Published Online:23 December 2020
Copyright Holders:Copyright © 2020 Asian Pacific Society of Nephrology
First Published:First published in Nephrology 26(4): 328-332
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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