Background Immunocompromised patients shed SARS-CoV-2 for extended periods, but to our knowledge person-to-person transmission from late shedding has not been reported. The case We present a case in which a COVID-19 patient infected another over 28 days after the patient’s initial symptoms, past current guideline recommendations of 20 days for length of isolation in immunocompromised patients. Whole genome sequencing of their viruses was performed to ascertain the transmission. Discussion Severely immunocompromised patients, whose clearance of the virus is impaired, may remain infectious for extended periods. Caution should be taken particularly in hospital settings where lapses in isolation procedures might pose increased risk, especially to other immunocompromised patients.

Background The COVID-19 epidemic overwhelmed local contact tracing (CT) efforts in many countries. In Finland, SARS-Cov-2 incidence and mortality were among the lowest in Europe during 2020-2021. We evaluated CT efficiency, effectiveness, and transmission settings. Methods PCR test-positive COVID-19 cases and high-risk contacts in the population-based CT database of Pirkanmaa Hospital District (pop. 540,000) during June 2020–May 2021 were interviewed. Results Altogether 353,926 PCR tests yielded 4,739 (1.3%) confirmed cases (average 14-day case notification rate, 34 per 100,000 population); about 99% of confirmed cases and high-risk contacts were reached by contact tracing team. Of 26,881 high-risk contacts who were placed in quarantine, 2,275 subsequently tested positive (48% of new cases), 825 (17%) had been in quarantine ≥48 h before symptoms, and 3,469 (77%) of locally acquired cases were part of transmission chains with an identified setting. Highest secondary attack rates were seen in households (31%), health care patients (18%), and private functions (10%). Among the 311 hospitalized patients, COVID-19 diagnosis or exposure was known in 273 (88%) before emergency room admission (identified patients). Health care workers had the highest proportion of work-related infections (159 cases, 35%). The source of infection was classifiable in 65% and was most commonly a co-worker (64 cases, 62%). Conclusions Our data demonstrates the role of effective testing and CT implementation during cluster phase of COVID-19 spread. Although half of newly diagnosed cases were already in quarantine, targeted public health measures were needed to control transmission. CT effectiveness during widespread community transmission should be assessed.

The incidence of venous thromboembolism (VTE) for non‐hospitalised patients with coronavirus disease‐2019 infection has not been very widely studied. 13 019 persons with a positive SARS‐CoV‐2 nucleic acid amplification test were identified. In total, 447 (0.2%) VTEs were identified in the study population, 293 (66%) of these were pulmonary embolisms. A positive SARS‐CoV‐2 test did not increase the risk for VTE in the univariate analysis (odds ratio (OR): 1.0, 95% confidence interval (CI): 0.69–1.4) or multivariable analysis (OR: 1.36, 95% CI: 0.93–1.97).

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