Browsing by Author "Hassan, Ahmed M."

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    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 Medicine
    In 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.
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    Re-infection with different SARS-CoV-2 clade and prolonged viral shedding in a patient with hematopoietic stem cell transplantation: SARS-CoV-2 Re-infection with different clade
    (Elsevier, 2021-07-18) Alshukairi, Abeer N.; El-Kafrawy, Sherif A.; Dada, Ashraf; Yasir, Mohamed; Yamani, Amani H.; Saeedi, Mohammed F.; Aljohaney, Ahmed; AlJohani, Naif I.; Bahaudden, Husam A.; Alam, Intikhab; Gojobori, Takashi; Radovanovic, Aleksandar; Alandijany, Thamir A.; Othman, Norah A.; Alsubhi, Tagreed L.; Hassan, Ahmed M.; Tolah, Ahmed M.; Al-Tawfiq, Jaffar A.; Zumla, Alimuddin; Azhar, Esam I.; Medicine, School of Medicine
    Immunocompromised patients who have SARS-CoV-2 infection pose many clinical and public health challenges. We describe a patient with hematopoietic stem cell transplantation and lymphoma with protracted illness requiring 3 consecutive hospital admissions. Whole genome sequencing confirmed two different SARS-CoV-2 clades. Clinical management issues, and unanswered questions arising are discussed.
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    Test-based De-isolation in COVID-19 Immunocompromised patients: Ct value versus SARS-CoV-2 viral cultures
    (Elsevier, 2021-05) Alshukairi, Abeer N.; Tolah, Ahmed M.; Dada, Ashraf; Al-Tawfiq, Jaffar A.; Almagharbi, Reem S.; Saeedi, Mohammed F.; Al-Hamzi, Mohammed A.; El-Kafrawy, Sherif A.; Bahaudden, Husam A.; El-Saeed, Aiman; Al-Mozaini, Maha A.; Khalid, Imran; Hefni, Lama K.; Hassan, Ahmed M.; Alandijany, Thamir A.; Bajrai, Leena H.; Bayumi, Daniyah T.; Albishi, Ghadeer E.; Althawadi, Sahar I.; Zabani, Najla A.; Perlman, Stanley; Azhar, Esam I.; Medicine, School of Medicine
    Background Immunocompromised patients with coronavirus disease 2019 (COVID-19) have prolonged infectious viral shedding for more than 20 days. A test-based approach is suggested for de-isolation of these patients. Methods The strategy was evaluated by comparing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load (cycle threshold (Ct) values) and viral culture at the time of hospital discharge in a series of 13 COVID-19 patients: six immunocompetent and seven immunocompromised (five solid organ transplant patients, one lymphoma patient, and one hepatocellular carcinoma patient). Results Three of the 13 (23%) patients had positive viral cultures: one patient with lymphoma (on day 16) and two immunocompetent patients (on day 7 and day 11). Eighty percent of the patients had negative viral cultures and had a mean Ct value of 20.5. None of the solid organ transplant recipients had positive viral cultures. Conclusions The mean Ct value for negative viral cultures was 20.5 in this case series of immunocompromised patients. Unlike those with hematological malignancies, none of the solid organ transplant patients had positive viral cultures. Adopting the test-based approach for all immunocompromised patients may lead to prolonged quarantine. Large-scale studies in disease-specific populations are needed to determine whether a test-based approach versus a symptom-based approach or a combination is applicable for the de-isolation of various immunocompromised patients.