Hostname: page-component-848d4c4894-tn8tq Total loading time: 0 Render date: 2024-07-01T22:09:04.606Z Has data issue: false hasContentIssue false

Duration of isolation and contagiousness in coronavirus disease 2019 (COVID-19) patients receiving tocilizumab and dexamethasone: A case series

Published online by Cambridge University Press:  09 February 2022

Florence Côté
Affiliation:
Department of Microbiology and Infectious Diseases, Centre Hospitalier Universitaire de Québec–Université Laval, Québec, QC, Canada
Guy Boivin
Affiliation:
Department of Microbiology and Infectious Diseases, Centre Hospitalier Universitaire de Québec–Université Laval, Québec, QC, Canada Virology Research Center, Centre Hospitalier Universitaire de Québec–Université Laval, Québec, QC, Canada
Vilayvong Loungnarath
Affiliation:
Department of Microbiology and Infectious Diseases, Centre Hospitalier Universitaire de Québec–Université Laval, Québec, QC, Canada
Annie Ruest
Affiliation:
Department of Microbiology and Infectious Diseases, Centre Hospitalier Universitaire de Québec–Université Laval, Québec, QC, Canada
Julie Bestman-Smith
Affiliation:
Department of Microbiology and Infectious Diseases, Centre Hospitalier Universitaire de Québec–Université Laval, Québec, QC, Canada
Julie Carbonneau
Affiliation:
Virology Research Center, Centre Hospitalier Universitaire de Québec–Université Laval, Québec, QC, Canada
Marie-Ève Hamelin
Affiliation:
Virology Research Center, Centre Hospitalier Universitaire de Québec–Université Laval, Québec, QC, Canada
Marie-Claude Roy*
Affiliation:
Department of Microbiology and Infectious Diseases, Centre Hospitalier Universitaire de Québec–Université Laval, Québec, QC, Canada
*
Author for correspondence: Marie-Claude Roy, E-mail: marie-claude.roy.med3@ssss.gouv.qc.ca

Abstract

We describe 10 patients with severe coronavirus disease 2019 (COVID-19) who received tocilizumab and dexamethasone. We correlated isolation duration with cycle thresholds (Ct) values of nucleic acid amplification tests, clinical state and viral cultures. Isolation duration exceeded 21 days for 7 patients due to positive viral cultures or Ct values <30.

Type
Concise Communication
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cogliati Dezza, F, Oliva, A, Cancelli, F, et al. Determinants of prolonged viral RNA shedding in hospitalized patients with SARS-CoV-2 infection. Diagn Microbiol Infect Dis 2021;100:115347.CrossRefGoogle ScholarPubMed
Van Kampen, JJA, Van de Vijver, D, Fraaij, P, et al. Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19). Nat Commun 2021;12:267.CrossRefGoogle ScholarPubMed
Hawken, SE, Sellers, SA, Smedberg, JR, et al. Longitudinal SARS-CoV-2 testing is punctuated by intermittent positivity and variable rates of cycle-threshold decline. medRxiv 2021. doi: 10.1101/2021.10.01.21264373.CrossRefGoogle Scholar
Interim guidance on ending isolation and precautions for adults with COVID-19. Center for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html. Published September 14, 2021. Accessed November 5, 2021.Google Scholar
Giles, AJ, Hutchinson, MND, Sonnemann, HM, et al. Dexamethasone-induced immunosuppression: mechanisms and implications for immunotherapy. J Immunother Cancer 2018;6:51.CrossRefGoogle ScholarPubMed
Sebba, A. Tocilizumab: the first interleukin-6-receptor inhibitor. Am J Health Syst Pharm 2008;65:14131418.CrossRefGoogle ScholarPubMed
Jefferson, T, Spencer, EA, Brassey, J, Heneghan, C. Viral cultures for COVID-19 infectious potential assessment—a systematic review. Clin Infect Dis 2020;ciaa1764.CrossRefGoogle Scholar
Longtin, Y, Charest, H, Quach, C, et al. Infectivity of healthcare workers diagnosed with coronavirus disease 2019 (COVID-19) approximately 2 weeks after onset of symptoms: a cross-sectional study. Infect Control Hosp Epidemiol 2022;43:102104.CrossRefGoogle ScholarPubMed
Lieberman, JA, Pepper, G, Naccache, SN, Huang, ML, Jerome, KR, Greninger, AL. Comparison of commercially available and laboratory-developed assays for in vitro detection of SARS-CoV-2 in clinical laboratories. J Clin Microbiol 2020;58(8):e0082120.CrossRefGoogle ScholarPubMed
Ong, SWX, Chiew, CJ, Ang, LW, et al. Clinical and virological features of SARS-CoV-2 variants of concern: a retrospective cohort study comparing B.1.1.7 (alpha), B.1.315 (beta), and B.1.617.2 (delta). Clin Infect Dis 2021. doi: 10.1093/cid/ciab721.CrossRefGoogle Scholar