Different Comorbid Conditions In COVID-19 Patients Can Impac
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Individuals diagnosed with COVID-19 who are aged 60+ have three or more chronic medical conditions, particularly diabetes, obesity, rheumatologic disease, or an organ transplant, have positive PCR tests for longer periods of time compared to younger individuals without these comorbidities. However, the data showed no significant difference in the duration of positive PCR results by the degree of immunocompromise or for individuals receiving chemotherapy or steroids to treat the condition.

The researchers examined data from 3,758 individuals who were retested using the SARS-CoV-2 PCR test following an initial positive result. The individuals were separated into groups by age as well as immunocompromised severity:

~ Severe - active chemotherapy, HIV with a CD4 count less than 200, organ transplant in the last year, or chronic high-dose steroids (7.4 percent of study group)

~ Moderate - solid organ transplant recipient greater than 1 year prior, HIV with a CD4 count greater than 200, and others taking chronic biologic medications (4.2 percent of study group)

~ Not immunocompromised (88.4 percent of study group)

The median length of time for severely immunocompromised patients to receive a negative SARS-CoV-2 PCR test result was 22 days; for moderately and non-immunocompromised individuals, the time was 20 and 16 days, respectively. For individuals who had a solid organ transplant, are older than 60, have diabetes, obesity or rheumatologic disease, as well as those with more than three comorbid conditions, it took longer for a negative SARS-CoV-2 PCR test result.

The authors note that retesting recommendations should perhaps consider a combination of conditions or include only certain groups of extremely immunocompromised individuals. There have been a few cases in the literature showing positive COVID1-9 test results months out from initial infection in patients who have undergone a solid organ or bone marrow transplant or received chimeric antigen receptor (CAR) T-cell therapy.

Additional studies that directly measure transmission or transmissibility from individuals with a positive PCR test result more than 20 days into illness with COVID-19 would be helpful to better inform current CDC guidelines.

Dr. S●●●●●●t S●●●●●●r and 1 others like this