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Longer Duration of SARS-CoV-2 Infection in a Case of Mild COVID-19 With Weak Production of the Specific IgM and IgG Antibodies.
Front Immunol. 2020; 11:1936.FI

Abstract

Background: The relationship between SARS-CoV-2-carrying time and specific antibody production has not yet been reported in re-admitted COVID-19 patients. We reported a case of mild COVID-19 with long virus-carrying time, weak production of virus-specific IgG and IgM antibodies, and recurrence of positive SARS-CoV-2 RNA in stool specimens after discharge. Case Presentation: A 27-year-old male was diagnosed as COVID-19 after returning to Meizhou from Wuhan. Despite extremely mild symptoms, the patient was hospitalized for 24 days because of persistent positive SARS-CoV-2 RNA detection. Three days after recovery discharge, he was hospitalized again for 7 days due to a recurrence of the positive SARS-CoV-2 RNA result, while in a good physical condition. Serological assay, using a fluorescent immunochromatography detection kit specific to SARS-CoV-2, showed that SARS-CoV-2-specific IgM antibodies were undetectable and IgG antibodies were very low on day 8 after onset; both of the antibodies seemingly reached top concentrations on day 15 (just a 6-fold increase of the IgG titer), and then decreased, remaining relatively stable from day 25 after onset until discharge. The production of the IgM and IgG targeting SARS-CoV-2 in this very mild case was much lower than that in a severe case of COVID-19 during the same hospitalizing period, and the latter was used as a control. Conclusion: Mild COVID-19 patients could carry SARS-CoV-2 for a long time, which may be related to the weak production of the virus-specific IgG and IgM. Recurrence of positive SARS-CoV-2 RNA could occur in mild COVID-19 possibly due to intermittent virus shedding, so strict quarantine and health surveillance should be taken for all discharged COVID-19 patients to prevent a potential virus spread.

Authors+Show Affiliations

Meizhou People's Hospital, Meizhou, China. Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translation Research of Hakka Population, Meizhou, China.Meizhou People's Hospital, Meizhou, China. Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translation Research of Hakka Population, Meizhou, China.Meizhou People's Hospital, Meizhou, China. Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translation Research of Hakka Population, Meizhou, China.Meizhou People's Hospital, Meizhou, China. Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translation Research of Hakka Population, Meizhou, China.Meizhou People's Hospital, Meizhou, China. Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translation Research of Hakka Population, Meizhou, China.Meizhou People's Hospital, Meizhou, China. Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translation Research of Hakka Population, Meizhou, China.

Pub Type(s)

Case Reports
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32849650

Citation

Guo, Xuemin, et al. "Longer Duration of SARS-CoV-2 Infection in a Case of Mild COVID-19 With Weak Production of the Specific IgM and IgG Antibodies." Frontiers in Immunology, vol. 11, 2020, p. 1936.
Guo X, Zeng L, Huang Z, et al. Longer Duration of SARS-CoV-2 Infection in a Case of Mild COVID-19 With Weak Production of the Specific IgM and IgG Antibodies. Front Immunol. 2020;11:1936.
Guo, X., Zeng, L., Huang, Z., He, Y., Zhang, Z., & Zhong, Z. (2020). Longer Duration of SARS-CoV-2 Infection in a Case of Mild COVID-19 With Weak Production of the Specific IgM and IgG Antibodies. Frontiers in Immunology, 11, 1936. https://doi.org/10.3389/fimmu.2020.01936
Guo X, et al. Longer Duration of SARS-CoV-2 Infection in a Case of Mild COVID-19 With Weak Production of the Specific IgM and IgG Antibodies. Front Immunol. 2020;11:1936. PubMed PMID: 32849650.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Longer Duration of SARS-CoV-2 Infection in a Case of Mild COVID-19 With Weak Production of the Specific IgM and IgG Antibodies. AU - Guo,Xuemin, AU - Zeng,Lizhu, AU - Huang,Zhen, AU - He,Yongjun, AU - Zhang,Zhuojin, AU - Zhong,Zhixiong, Y1 - 2020/08/07/ PY - 2020/05/21/received PY - 2020/07/17/accepted PY - 2020/8/28/entrez PY - 2020/8/28/pubmed PY - 2020/9/22/medline KW - SARS-CoV-2 KW - case report KW - mild COVID-19 KW - persistent infection KW - virus-specific antibody response SP - 1936 EP - 1936 JF - Frontiers in immunology JO - Front Immunol VL - 11 N2 - Background: The relationship between SARS-CoV-2-carrying time and specific antibody production has not yet been reported in re-admitted COVID-19 patients. We reported a case of mild COVID-19 with long virus-carrying time, weak production of virus-specific IgG and IgM antibodies, and recurrence of positive SARS-CoV-2 RNA in stool specimens after discharge. Case Presentation: A 27-year-old male was diagnosed as COVID-19 after returning to Meizhou from Wuhan. Despite extremely mild symptoms, the patient was hospitalized for 24 days because of persistent positive SARS-CoV-2 RNA detection. Three days after recovery discharge, he was hospitalized again for 7 days due to a recurrence of the positive SARS-CoV-2 RNA result, while in a good physical condition. Serological assay, using a fluorescent immunochromatography detection kit specific to SARS-CoV-2, showed that SARS-CoV-2-specific IgM antibodies were undetectable and IgG antibodies were very low on day 8 after onset; both of the antibodies seemingly reached top concentrations on day 15 (just a 6-fold increase of the IgG titer), and then decreased, remaining relatively stable from day 25 after onset until discharge. The production of the IgM and IgG targeting SARS-CoV-2 in this very mild case was much lower than that in a severe case of COVID-19 during the same hospitalizing period, and the latter was used as a control. Conclusion: Mild COVID-19 patients could carry SARS-CoV-2 for a long time, which may be related to the weak production of the virus-specific IgG and IgM. Recurrence of positive SARS-CoV-2 RNA could occur in mild COVID-19 possibly due to intermittent virus shedding, so strict quarantine and health surveillance should be taken for all discharged COVID-19 patients to prevent a potential virus spread. SN - 1664-3224 UR - https://www.unboundmedicine.com/medline/citation/32849650/Longer_Duration_of_SARS_CoV_2_Infection_in_a_Case_of_Mild_COVID_19_With_Weak_Production_of_the_Specific_IgM_and_IgG_Antibodies_ DB - PRIME DP - Unbound Medicine ER -