{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T14:01:25Z","timestamp":1758636085974,"version":"3.44.0"},"reference-count":20,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,10,15]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:p>Renal transplant (RT) recipients are at increased risk for infectious complications. The clinical course of COVID-19 has been described in several RT recipients with varying clinical outcomes. Most present with pulmonary manifestations, however extrapulmonary presentations are not uncommon. Also, the timing and efficacy of seroconversion in transplant recipients is not well known. This report describes the duration of viral shedding and timing of seroconversion in a young adult RT recipient with COVID-19 who presented with severe diarrhoea and acute kidney injury requiring dialysis. She developed anti\u2010SARS\u2010CoV\u20102 IgG antibody after 5\u2009weeks despite persistently shedding the virus in the nasopharynx until 6\u2009weeks after symptom onset. Further studies are needed to determine if immunosuppressed patients have prolonged viral shedding and are still contagious despite seroconversion.<\/jats:p>","DOI":"10.1136\/bcr-2020-239612","type":"journal-article","created":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T16:35:43Z","timestamp":1604939743000},"page":"e239612","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Persistent viral shedding despite seroconversion in a kidney transplant recipient with severe extrapulmonary COVID-19"],"prefix":"10.1136","volume":"13","author":[{"given":"Jack","family":"Italiano","sequence":"first","affiliation":[{"name":"Pediatric Nephrology, University of Florida Health, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Bush","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology, University of Florida Health, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ratna","family":"Acharya","sequence":"additional","affiliation":[{"name":"Pediatrics, University of Florida, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8441-0220","authenticated-orcid":false,"given":"Kiran","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology, University of Florida Health, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,11,9]]},"reference":[{"key":"2025082707493418000_13.11.e239612.1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05170420"},{"key":"2025082707493418000_13.11.e239612.2","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1186\/s13054-020-03009-y","article-title":"Incidence of acute kidney injury in COVID-19 infection: a systematic review and meta-analysis","volume":"24","author":"Chen","year":"2020","journal-title":"Crit Care"},{"key":"2025082707493418000_13.11.e239612.3","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2020030375"},{"key":"2025082707493418000_13.11.e239612.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)302518"},{"key":"2025082707493418000_13.11.e239612.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30196-1"},{"key":"2025082707493418000_13.11.e239612.6","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.3201\/eid2607.200841","article-title":"Severe acute respiratory syndrome coronavirus 2-specific antibody responses in coronavirus disease patients","volume":"26","author":"Okba","year":"2020","journal-title":"Emerg Infect Dis"},{"key":"2025082707493418000_13.11.e239612.7","first-page":"ciaa344","article-title":"Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019","author":"Zhao","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2025082707493418000_13.11.e239612.8","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.jinf.2020.03.012","article-title":"Profile of specific antibodies to SARS-CoV-2: the first report","volume":"81","author":"Xiao","year":"2020","journal-title":"J Infect"},{"key":"2025082707493418000_13.11.e239612.9","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2196-x"},{"key":"2025082707493418000_13.11.e239612.10","doi-asserted-by":"crossref","first-page":"117011","DOI":"10.1016\/j.jns.2020.117011","article-title":"Seroconversion and indolent course of COVID-19 in patients with multiple sclerosis treated with fingolimod and teriflunomide [published online ahead of print, 2020 Jul 4]","volume":"416","author":"Bollo","year":"2020","journal-title":"J Neurol Sci"},{"key":"2025082707493418000_13.11.e239612.11","article-title":"Influence of immunosuppression on seroconversion against SARS-CoV-2 in two kidney transplant recipients","author":"Wang","year":"2020","journal-title":"Transpl Infect Dis"},{"key":"2025082707493418000_13.11.e239612.12","first-page":"30454","article-title":"Clinical recurrences of COVID-19 symptoms after recovery: Viral relapse, reinfection or inflammatory rebound? 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