Background The duration of viable Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) shedding in immunocompromised patients is still unknown. This case report describes the duration of viable SARS-CoV-2 in two immunocompromised patients with completely different clinical courses and further addresses the immunological aspects. Case presentations Oropharyngeal swaps were collected continuously during hospitalization for two immunocompromised patients infected with SARS-CoV-2 and sent for analysis to real time reverse transcription polymerase chain reaction (RT-PCR), viral culture assessed by plaque assay and full genome sequencing. Blood samples for flow cytometry and further immunological analysis were taken once during admission. One patient was without symptoms of Coronavirus disease 2019 (COVID-19) whereas the other had severe respiratory symptoms requiring a stay at an intensive care unit (ICU) and treatment with remdesivir and dexamethasone. Despite their difference in clinical courses, they both continuously shed SARS-CoV-2 with high viral loads in culture. Both patients had undetectable anti SARS-CoV-2 IgG levels about 2 weeks after the first positive real time RT-PCR test of SARS-CoV-2, marked expansions of virus reactive CD8+ T cells but cellular markers indicative of attenuated humoral immunity. Conclusions Our case illustrates the importance of distinguishing isolation guidelines for patients infected with SARS-CoV-2 according to their immunological status. Furthermore, it demonstrates the need for immune markers relating to viral shedding in immunocompromised patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06429-5.
【저자키워드】 COVID-19, SARS-CoV-2, Immunocompromised host, Virus shedding, 【초록키워드】 Dexamethasone, Treatment, coronavirus disease, severe acute respiratory syndrome coronavirus 2, Coronavirus disease 2019, coronavirus, intensive care, Hospitalization, T cells, intensive care unit, viral shedding, Immunocompromised patients, Remdesivir, RT-PCR, virus, coronavirus 2, flow cytometry, Case report, ICU, Immunocompromised patient, reverse transcription polymerase chain reaction, polymerase chain reaction, Humoral immunity, Genome sequencing, Clinical course, Viral, Culture, Viral load, Patient, Isolation, Immunocompromised, reverse transcription, respiratory, PCR test, viral culture, Admission, SARS-CoV-2 IgG, CD8+ T cell, marker, cellular, RT-PCR test, Plaque assay, Analysis, real time, respiratory symptoms, Chain Reaction, during admission, clinical courses, acute respiratory syndrome, supplementary material, Blood samples, one patient, blood sample, severe respiratory symptoms, full genome sequencing, immune markers, courses, immunological, reactive, first positive, polymerase chain, collected, immune marker, infected with SARS-CoV-2, severe respiratory symptom, undetectable, without symptom, 【제목키워드】 Case report, Prolonged,