A new positive SARS-CoV-2 test months after severe COVID-19 illness: reinfection or intermittent viral shedding?

BMJ Case Rep. 2021 Feb 4;14(2):e240531. doi: 10.1136/bcr-2020-240531.

Abstract

We present a case of a patient who had a history of severe coronavirus disease (COVID-19) 4 months prior to this current presentation and, after a long asymptomatic period, subsequently tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by a RNA PCR assay, after several interval negative SARS-CoV-2 RNA tests. We present this potential case of SARS-CoV-2 reinfection in order to incite discussion around differentiating persistent infection with intermittent viral shedding and reinfection, as well as to discuss evolving knowledge and approaches to the clinical management, follow-up molecular testing and treatment of COVID-19 reinfection.

Keywords: COVID-19; immunology; pneumonia (infectious disease).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • COVID-19 / diagnosis*
  • COVID-19 / therapy
  • COVID-19 / virology
  • Humans
  • Intensive Care Units
  • Male
  • RNA, Viral / isolation & purification
  • Radiography / methods
  • Reinfection / diagnosis*
  • Reinfection / therapy
  • Reinfection / virology*
  • SARS-CoV-2 / isolation & purification*
  • Treatment Outcome
  • Virus Shedding*

Substances

  • Antibodies, Monoclonal, Humanized
  • RNA, Viral
  • tocilizumab