Virus infectivity and within host evolution post SARS-CoV-2 infection [COVID-19}
Research type
Research Study
Full title
Evaluation of duration of viral shedding, infectivity and within-host virus evolution of SARS-CoV-2 post COVID-19 infection in immunocompromised patients
IRAS ID
283496
Contact name
Anna Smielewska
Contact email
Sponsor organisation
Cambridge University Hospitals, NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Patients who test positive for SARS-CoV-2 are, according to current guidelines, no longer thought to be infectious when their symptoms have stopped, and they have had two negative tests 24 hours apart.\nThere are problems with this approach: Immunocompromised patients can continue to shed virus, and test positive for a long time; and the test that is used to check for virus only detects a small part of the virus, and not whether the virus is infectious to other people.\nUsing this approach can lead to unnecessary isolation precautions, delay to hospital discharge, and delay to the delivery of specialised patient care. \nThere is an urgent need to find out if patients who continue to test positive or who test positive intermittently are infectious, and how much risk they pose to their contacts. Whether the virus can continue to evolve in these patients with prolonged positive results is of interest to the wider community, and may indicated the emergence of new strains of SARS-CoV-2. \nTo investigate, and provide answers to these problems:\nWe will collect and analysed data on the frequency of testing of individual patients in order to produce evidence-based guidelines on optimum testing intervals;\nWe will collect patient data (link-anonymised) including levels of immunosuppression on patients with more than one positive test to feed in to these guidelines;\nWe will store left over diagnostic samples from these patients until attempts can be made to grow them in cell culture to establish whether they contain live virus that can potentially be infectious;\nWe will, in collaboration with COG-UK, examine sequential samples from individual patients to establish whether prolonged infection, as is observed in immunocompromised patients, allows genetic changes to the virus.\n
REC name
West Midlands - Solihull Research Ethics Committee
REC reference
20/WM/0193
Date of REC Opinion
30 Jun 2020
REC opinion
Favourable Opinion