Evidence map›Paper›PMID 40394759›Full record

SynthesisInfluenza and other respiratory viruses2025

A Systematic Review of Prolonged SARS-CoV-2 Shedding in Immunocompromised Persons.

Rebecca C Christofferson, Jennifer E Giovanni, Emily H Koumans, Muyiwa Ategbole, Samantha D Clark, Shana Godfred-Cato, Manoj P Menon, Inka Sastalla, Beth K Schweitzer, Timothy M Uyeki

Erratum issuedAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Influenza and other respiratory viruses, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Persistent COVID-19 Pneumonia in a Patient on Rituximab.Journal of investigative medicine high impact case reports
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Rebecca C ChristoffersonLouisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana, USA.
Jennifer E GiovanniCenters for Disease Control and Prevention, Atlanta, Georgia, USA.
Emily H KoumansCenters for Disease Control and Prevention, Atlanta, Georgia, USA.
Muyiwa AtegboleCenters for Disease Control and Prevention, Atlanta, Georgia, USA.
Samantha D ClarkLouisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana, USA.ORCID 0000-0002-7209-3504
Shana Godfred-CatoCenters for Disease Control and Prevention, Atlanta, Georgia, USA.
Manoj P MenonFred Hutchinson Cancer Center Seattle, Seattle, Washington, USA.
Inka SastallaOffice of Genomics and Advanced Technologies, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Beth K SchweitzerLouisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana, USA.
Timothy M UyekiLouisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana, USA.ORCID 0000-0001-5338-8668

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough reports have documented prolonged SARS-CoV-2 RNA detection in immunocompromised patients, few studies have systematically analyzed data on duration of SARS-CoV-2 in respiratory specimens of immunocompromised patients.

methodsA systematic review was undertaken to describe SARS-CoV-2 RNA and infectious virus detection in immunocompromised patients from published data between January 1, 2020 and July 1, 2022. Patients were included if there was ≥ 1 positive SARS-CoV-2 RNA result in respiratory specimens collected > 20 days since symptom onset or first positive SARS-CoV-2 RT-PCR result.

resultsOf the 183 patients, 175 were symptomatic with 83 (47.4%) that experienced intermittent relapsing symptoms, while pneumonia was reported in 122 (66.7%). Immunocompromising conditions represented were hematologic malignancy treatment (89, 48.6%), solid organ transplant (47, 25.7%), autoimmune disease treatment (14, 7.7%), solid tumor treatment (3, 1.6%), HIV infection (15, 8.2%), and primary immunodeficiency (15, 8.2%). Median duration from the first to the last positive SARS-CoV-2 RT-PCR result was 56 days in upper respiratory and 60 days in lower respiratory tract specimens. Significant differences in median duration of SARS-CoV-2 RNA detection were observed between patients with and without pneumonia and for patients with hematologic malignancies compared to solid organ transplant patients. Among patients with viral culture performed, median duration of replication-competent SARS-CoV-2 was 60.5 days from symptom onset (maximum 238 days) and 59 days from first RT-PCR positive result (maximum 268 days).

conclusionsImmunocompromised persons can have replication-competent SARS-CoV-2 in respiratory tissues for months, including while asymptomatic. Serial SARS-CoV-2 testing can inform the duration of isolation for immunocompromised patients with SARS-CoV-2 infection.

Indexed as

COVID-19Immunocompromised HostSARS-CoV-2Virus SheddingHumansRNA, ViralRNA, ViralCOVID‐19immunocompromisedSARS‐CoV‐2

Identifiers

PMID40394759
PMCPMC12092234

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.