To identify risk factors for prolonged viral shedding (PVS) and profile immune deficits in patients with hematologic disease (HD) during Omicron infection, where PVS is defined as the persistence of detectable virus beyond typical clearance times.
Key Findings:
13.3% of patients with HD developed Omicron breakthrough infections.
36.9% of analyzed patients exhibited prolonged viral shedding.
Significant depletion of CD4+ and CD19+ cells in patients with PVS compared to those without.
Higher frequency of exhausted T-cells in patients with PVS.
Patients with PVS had significantly lower neutralizing activity against Omicron subvariants.
Interpretation:
Patients with hematologic disease are at increased risk for prolonged viral shedding during Omicron infection, which is associated with specific immunological deficits, particularly in CD4+ T-cells and neutralizing antibody responses.
Limitations:
Retrospective design may limit causative conclusions, potentially affecting the reliability of the findings.
Sample size for detailed immunological analysis was small, which may limit the generalizability of the results.
Conclusion:
Prolonged viral shedding in hematologic patients during Omicron infection is linked to immune deficiencies, particularly involving CD4+ T-cells and neutralizing antibody responses.
