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Browsing by Author "Al Hroub, Mohammad K."
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Item Active viral shedding in a vaccinated hospitalized patient infected with the delta variant (B.1.617.2) of SARS-CoV-2 and challenges of de-isolation(Elsevier, 2022) Alshukairi, Abeer N.; Al-Omari, Awad; Al-Tawfiq, Jaffar A.; El-Kafrawy, Sherif A.; El-Daly, Mai M.; Hassan, Ahmed M.; Faizo, Arwa A.; Alandijany, Thamir A.; Dada, Ashraf; Saeedi, Mohammed F.; Alhamlan, Fatma S.; Al Hroub, Mohammad K.; Qushmaq, Ismael; Azhar, Esam I.; Medicine, School of MedicineIn the era of SARS-CoV-2 variants and COVID-19 vaccination, the duration of infectious viral shedding and isolation in post vaccine breakthrough infections is challenging and depends on disease severity. The current study described a case of SARS-CoV-2 Delta variant pneumonia requiring hospitalization. The patient received two doses of BNT162b2 COVID-19 vaccines, and he had positive SARS-CoV-2 viral cultures 12 days post symptom onset. The time between the second dose of vaccine and the breakthrough infection was 6 months. While immunosuppression is a known risk factor for prolonged infectious viral shedding, age and time between vaccination and breakthrough infection are important risk factors that warrant further studies.Item De-isolation of vaccinated COVID-19 health care workers using rapid antigen detection test(Elsevier, 2022) Alshukairi, Abeer N.; Al-Omari, Awad; Al Hroub, Mohammad K.; Al-Tawfiq, Jaffar A.; Qutub, Mohammed; Shaikh, Samaher; Allali, Khalid; Saeedi, Mohammed F.; Alosaimi, Roaa S.; Alamoudi, Elaf; Hefni, Lama K.; El-Saed, Aiman; Alhamlan, Fatma S.; Dada, Ashraf; Wali, Ghassan Y.; Medicine, School of MedicineBackground: COVID-19 de-isolation guidelines of health care workers (HCW) were formulated based on evidence describing the duration of infectious viral shedding of the wild SARS-CoV-2 virus. During the periods of COVID-19 vaccination and variants, a test-based approach was recommended to end isolation of HCW, based on emerging data describing the viral kinetics of COVID-19 variants. While Rapid antigen detection tests (RADT) are increasingly used in the diagnosis of COVID-19, their use is limited in de-isolation. Methods: We described the use of RADT in the de-isolation of COVID-19 vaccinated HCW with mild infection who were asymptomatic on day 7 post diagnosis in a single center retrospective cohort study during the Omicron surge. Results: Of the 480 HCWs, 173 (36%) had positive RADT. The positivity rate of RADT was not different in HCW who received two doses versus three doses of vaccine (34.4% versus 40.3%, p = 0.239). Conclusions: A symptom based, test-based approach using RADT is a useful tool in the de-isolation of HCW, with mild disease, in the era of Omicron. Further studies are required to evaluate the role of RADT in de-isolation of patients with severe COVID-19 disease.Item Outcome of SARS-CoV-2 variant breakthrough infection in fully immunized solid organ transplant recipients(Elsevier, 2022) Almaghrabi, Reem S.; Alhamlan, Fatimah S.; Dada, Ashraf; Al-Tawfiq, Jaffar A.; Al Hroub, Mohammad K.; Saeedi, Mohammed F.; Alamri, Maha; Alhothaly, Bushra; Alqasabi, Abdulmohsin; Al-Qahtani, Ahmed A.; Al-Omari, Awad; Alshukairi, Abeer N.; Medicine, School of MedicineSARS-CoV-2 vaccination in solid organ transplant recipients is associated with suboptimal immune response and risk for breakthrough infection. It is not known whether they are at risk of severe post-vaccine breakthrough infections in the presence of SARSCoV-2 variant of concern. We describe a case series of four fully vaccinated solid organ transplant recipients who developed SARS-CoV-2 variants of concern breakthrough infections. Three patients received BNT162b2 mRNA (Pfizer-BioNTech) and one patient received ChAdOx1 (AZD12220) COVID-19 vaccines. The patients were infected with SARS-CoV-2 variants circulating in Saudi Arabia. Two patients were infected with Alpha variant and had severe pneumonia requiring intensive care admission and ventilatory support and subsequently died. The other two patients recovered; one patient was infected with Beta variant required low supplemental oxygen via nasal flow and the other patient was infected with Delta variant and required high supplemental oxygen nasal flow. Younger patients had a better outcome than older patients. Future large studies are required to confirm our observations and to compare the different vaccine efficacy among solid organ transplants in the era of SARS-CoV-2 variants of concern.