Infection and Drug Resistance (Dec 2023)

Prolonged Viral Shedding in Cancer Patients with Asymptomatic or Mild Omicron Infection: A Retrospective Study

  • Yang Q,
  • He Y,
  • Zhou Y,
  • Jia Q,
  • Dai N,
  • Ma S,
  • Yang X,
  • Zhang X,
  • Sun J

Journal volume & issue
Vol. Volume 16
pp. 7735 – 7741

Abstract

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Qiao Yang,1,* Ying He,2,* Yi Zhou,3 Qinzhu Jia,3 Nan Dai,4 Siyuan Ma,5 Xiu Yang,3 Xi Zhang,6 Jianguo Sun3 1Department of Ultrasound, The 941st Hospital of the PLA Joint Logistic Support Force, Xining, 810007, People’s Republic of China; 2Department of Psychiatry, Xinqiao Hospital, Army Medical University, Chongqing, 400037, People’s Republic of China; 3Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing, 400037, People’s Republic of China; 4Department of Oncology, Daping Hospital, Army Medical University, Chongqing, 400042, People’s Republic of China; 5Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Army Medical University, Chongqing, 400038, People’s Republic of China; 6Department of Hematology, Xinqiao Hospital, Army Medical University, Chongqing, 400037, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianguo Sun; Xi Zhang, Xinqiao Hospital, Army Medical University, 83 Xinqiao Zhengjie Road, Shapingba District, Chongqing, 400037, People’s Republic of China, Tel +86-23-68774490, Fax +86-23-68774631, Email [email protected]; [email protected]: This study aimed to investigate the risk factors for persistent viral shedding in cancer patients after Omicron infection.Methods: Patients with asymptomatic or mild Omicron infection (≥ 18 years) who were treated in a makeshift hospital in Shanghai were enrolled from 9 Apr to 11 May, 2022. Deidentified information of all patients were collected retrospectively. Logistic regression model was used to identify risk factors associated with prolonged duration of viral shedding (defined as the time from the day of first positive SARS-CoV-2 RNA test to the first day of two consecutive negative SARS-CoV-2 RNA tests).Results: A total of 1442 Omicron-infected patients were enrolled, including 129 cancer patients and 1313 non-cancer patients. The baseline clinical characteristics of cancer and non-cancer patients were balanced by propensity score matching (1:4). Compared with non-cancer patients, a higher odds ratio ([OR] 1.84, 95% CI 1.24– 2.76, P = 0.003) of lasting viral shedding for ≥ 7 days was found in cancer patients. Further subgroup analyses found that cancer patients were at higher risk for prolonged viral shedding in a subgroup of patients without hypertension (OR 1.89), diabetes (OR 1.80), or other chronic disease (OR 2.13), unvaccinated (OR 1.97), and asymptomatic (OR 2.36). In addition, 29 patients with active cancer and 19 patients with inactive cancer were identified. The median duration of viral shedding in the active cancer group was longer than that in the inactive cancer group (10 vs 6 days, P = 0.002). The risk of persistent viral shedding ≥ 7 days was also increased in the active cancer group (OR 5.33, 95% CI 1.49– 21.51, P = 0.013).Conclusion: Cancer disease is an independent risk factor for prolonged viral shedding in Omicron infected patients, especially in patients with active cancer.Keywords: omicron, cancer, persistent viral shedding, SARS-CoV-2

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