COVID-19 has surfaced as a multi-organ disease predominantly affecting the respiratory system. Detection of the viral RNA through reverse transcriptase–PCR (RT-PCR) from a nasopharyngeal or throat sample is the preferred method of diagnosis. Recent evidence has suggested that COVID-19 patients can shed the SARS-CoV-2 for several weeks. Herein, we report six cases of COVID-19 who had persistently positive SARS-CoV-2 on repeat RT-PCR testing reaching up to 9 weeks. The spectrum of cases described ranges from asymptomatic infection to severe COVID-19 pneumonia. A full understanding of the virus’s transmission dynamics needs further research. Prolonged viral shedding currently has unclear implications on the management and isolation decisions—the role of the cycle threshold (Ct) value in guiding therapeutic decisions is yet to be clarified. More data on the relationship between Ct values and viral cultivation are needed, especially in patients with prolonged viral shedding, to understand the virus’s viability and infectivity.
Introduction: Cryptococcal meningitis (CM) is an opportunistic and life-threatening infection, affecting mainly patients with AIDS. The aim of this study was to estimate the prevalence of CM and describe its clinical profile, laboratory parameters, and outcomes in patients with CM in Qatar. Patients and Methods: This retrospective study was conducted at Hamad General Hospital. This study includes all patients admitted to the hospital with CM from January 1, 2005, to December 31, 2015. Results: Eleven patients were included in the study, representing 0.01% of the total admissions and 1.1% of all reported meningitis cases during the study; their mean age was 38.5 ± 12 years. Seven patients (63.6%) were males, and most of them were Filipinos. The most frequent presenting symptom was a headache. Six patients (54.5%) were HIV seropositive, three (27.3%) had preexisting immunosuppressive disorders, and two patients (18.2%) had no risk factors. All the patients tested positive in the cerebrospinal fluid (CSF) India ink examination and had a positive CSF culture for Cryptococcus neoformans. All patients received amphotericin B or liposomal amphotericin B with or without 5-flucytosine as induction treatment. Ten patients received fluconazole as consolidation/maintenance therapy. Eight patients (72.7%) were cured at the end of the treatment period. Two patients (18.2%) left before treatment completion, while one patient (9%) died during admission. Conclusions: CM is rare in Qatar and affects both HIV-positive and HIV-negative expatriates. Clinical presentation is nonspecific and requires a high index of suspicion.
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