Evaluation of In-Hospital Cluster of COVID-19 Associated With a Patient With Prolonged Viral Shedding Using Whole-Genome Sequencing

Jiwon Jung, Jungmin Lee, Sun Kyung Kim, Soyeon Park, Young Ju Lim, Eun Ok Kim, Heedo Park, Man Seong Park, Sung Han Kim

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patients with hematologic malignancies may produce replication-competent virus beyond 20 days of SARS-CoV-2 infection. However, data regarding the transmission of SARS-CoV-2 from patients with prolonged viral shedding is limited. Methods: In May 2022, four additional cases of COVID-19 were reported in a hematologic ward at a tertiary care hospital in South Korea, after an 8-week isolation of a patient with prolonged viral shedding. We performed whole-genome sequencing (WGS) of SARS-CoV-2 to evaluate the possibility of post-isolation transmission from this prolonged viral shedding. Results: A patient (case 1) with acute myeloid leukemia was released from isolation 54 days after the diagnosis of COVID-19 based on rising Ct value of up to 29.3, and moved to a six-patient room. On days 10 and 11 post-isolation, his doctor (case 2) and 2 patients who were his roommates (case 3, 4) had positive SARS-CoV-2 PCR results. Additionally, 16 days post-isolation, another patient (case 5) in a remote room had positive SARS-CoV-2 PCR result. All the three patients were hospitalized for ≥ 14 days when they were diagnosed with SARS-CoV-2 infection. Except for case 3, the remaining 4 cases were available for WGS, which revealed that case 1 exhibited a 7 nucleotides difference in comparison to cases 4 and 5 and case 2 displayed a 20 nucleotides difference compared with case 1, while sequences of cases 4 and 5 were identical.

Original languageEnglish
Article numbere289
JournalJournal of Korean medical science
Volume37
Issue number39
DOIs
Publication statusPublished - 2022

Bibliographical note

Funding Information:
This work was supported by the Korea National Institute of Health (grant no. 2022-ER1609-00) and the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT, Republic of Korea (grant number: NRF-2022M3A9I2017241).

Publisher Copyright:
© 2022 The Korean Academy of Medical Sciences

Keywords

  • Covid-19
  • Hematologic malignancy
  • Post-isolation transmission
  • Sars-cov-2
  • Whole-genome sequencing

ASJC Scopus subject areas

  • General Medicine

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