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Persistent SARS-COV-2 RNA positivity in a patient for 92 days after disease onset: A case report.
Medicine (Baltimore). 2020 Aug 21; 99(34):e21865.M

Abstract

RATIONALE

Recently, patients with COVID-19 who showed persistently positive SARS-CoV-2 nucleic acid test results despite resolved clinical symptoms have attracted a lot of attention. We report the case of a patient with mild symptoms of coronavirus disease (COVID-19), who achieved clinical recovery but showed persistently positive SARS-CoV-2 nucleic acid test results until Day 92 after disease onset.

PATIENT CONCERNS

The patient is a 50-year-old man with mild symptoms of coronavirus disease (COVID-19).

DIAGNOSES

COVID-19 pneumonia.

INTERVENTIONS

The patient was quarantined for 105 days. Of these, inpatient quarantine lasted for 75 days. When the nucleic acid test results were negative for 3 consecutive days, the patient was discharged at Day 75 after disease onset. During this period, multiple samples were collected from the patient's body surface, the surrounding environment, and physical surfaces, but none of these tested positive for SARS-CoV-2. These samples included those from anal swabs, hands, inner surface of mask, cell phone, bed rails, floor around the bed, and toilet bowl surface. However, nucleic acid retest results on Day 80 and Day 92 after disease onset were positive for SARS-CoV-2 nucleic acids.

OUTCOMES

The patient continued with quarantine and observation at home. After the test results on Days 101 and 105 after disease onset were negative, quarantine was terminated at last.

LESSONS

Per our knowledge, this is the longest known time that a patient has tested positive for SARS-CoV-2 nucleic acids. No symptoms were observed during follow-up. During hospitalization, the SARS-CoV-2 nucleic acid positivity was not observed in samples from the body surface and surrounding environment, and no verified transmission event occurred during the quarantine at home. After undergoing clinical recovery a minority of patients with COVID-19 have shown long-term positive results for the presence of the SARS-CoV-2 nucleic acid. This has provided new understanding and research directions for coronavirus infection. Long-term follow-up and quarantine measures have been employed for such patients. Further studies are required to analyze potential infectivity in such patients and determine whether more effective antiviral drugs or regimens to enable these patients to completely clear viral infection should be researched.

Authors+Show Affiliations

Department of Infectious Diseases, Changzheng Hospital, Second Military Medical University, Shanghai.Department of Infectious Diseases, Changzheng Hospital, Second Military Medical University, Shanghai.Department of Infectious Diseases, Changzheng Hospital, Second Military Medical University, Shanghai.China PLA Institute for Disease Control and Prevention, Beijing, China.China PLA Institute for Disease Control and Prevention, Beijing, China.China PLA Institute for Disease Control and Prevention, Beijing, China.China PLA Institute for Disease Control and Prevention, Beijing, China.Department of Infectious Diseases, Changzheng Hospital, Second Military Medical University, Shanghai.China PLA Institute for Disease Control and Prevention, Beijing, China.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

32846839

Citation

Wang, Junxue, et al. "Persistent SARS-COV-2 RNA Positivity in a Patient for 92 Days After Disease Onset: a Case Report." Medicine, vol. 99, no. 34, 2020, pp. e21865.
Wang J, Hang X, Wei B, et al. Persistent SARS-COV-2 RNA positivity in a patient for 92 days after disease onset: A case report. Medicine (Baltimore). 2020;99(34):e21865.
Wang, J., Hang, X., Wei, B., Li, D., Chen, F., Liu, W., Yang, C., Miao, X., & Han, L. (2020). Persistent SARS-COV-2 RNA positivity in a patient for 92 days after disease onset: A case report. Medicine, 99(34), e21865. https://doi.org/10.1097/MD.0000000000021865
Wang J, et al. Persistent SARS-COV-2 RNA Positivity in a Patient for 92 Days After Disease Onset: a Case Report. Medicine (Baltimore). 2020 Aug 21;99(34):e21865. PubMed PMID: 32846839.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistent SARS-COV-2 RNA positivity in a patient for 92 days after disease onset: A case report. AU - Wang,Junxue, AU - Hang,Xiaofeng, AU - Wei,Bo, AU - Li,Dingchen, AU - Chen,Fangyan, AU - Liu,Wei, AU - Yang,Chaojie, AU - Miao,Xiaohui, AU - Han,Li, PY - 2020/8/28/entrez PY - 2020/8/28/pubmed PY - 2020/9/15/medline SP - e21865 EP - e21865 JF - Medicine JO - Medicine (Baltimore) VL - 99 IS - 34 N2 - RATIONALE: Recently, patients with COVID-19 who showed persistently positive SARS-CoV-2 nucleic acid test results despite resolved clinical symptoms have attracted a lot of attention. We report the case of a patient with mild symptoms of coronavirus disease (COVID-19), who achieved clinical recovery but showed persistently positive SARS-CoV-2 nucleic acid test results until Day 92 after disease onset. PATIENT CONCERNS: The patient is a 50-year-old man with mild symptoms of coronavirus disease (COVID-19). DIAGNOSES: COVID-19 pneumonia. INTERVENTIONS: The patient was quarantined for 105 days. Of these, inpatient quarantine lasted for 75 days. When the nucleic acid test results were negative for 3 consecutive days, the patient was discharged at Day 75 after disease onset. During this period, multiple samples were collected from the patient's body surface, the surrounding environment, and physical surfaces, but none of these tested positive for SARS-CoV-2. These samples included those from anal swabs, hands, inner surface of mask, cell phone, bed rails, floor around the bed, and toilet bowl surface. However, nucleic acid retest results on Day 80 and Day 92 after disease onset were positive for SARS-CoV-2 nucleic acids. OUTCOMES: The patient continued with quarantine and observation at home. After the test results on Days 101 and 105 after disease onset were negative, quarantine was terminated at last. LESSONS: Per our knowledge, this is the longest known time that a patient has tested positive for SARS-CoV-2 nucleic acids. No symptoms were observed during follow-up. During hospitalization, the SARS-CoV-2 nucleic acid positivity was not observed in samples from the body surface and surrounding environment, and no verified transmission event occurred during the quarantine at home. After undergoing clinical recovery a minority of patients with COVID-19 have shown long-term positive results for the presence of the SARS-CoV-2 nucleic acid. This has provided new understanding and research directions for coronavirus infection. Long-term follow-up and quarantine measures have been employed for such patients. Further studies are required to analyze potential infectivity in such patients and determine whether more effective antiviral drugs or regimens to enable these patients to completely clear viral infection should be researched. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/32846839/Persistent_SARS_COV_2_RNA_positivity_in_a_patient_for_92_days_after_disease_onset:_A_case_report_ L2 - https://doi.org/10.1097/MD.0000000000021865 DB - PRIME DP - Unbound Medicine ER -