A case report of moderate COVID-19 with an extremely long-term viral shedding period in China

Abstract

Background: An ongoing outbreak of novel coronavirus disease 2019 (COVID-19) from Wuhan, China, is currently recognized as a global public health emergency, which has subsequently spread to the rest of China and other countries. The WHO raised the COVID-19 alert to the highest level. The virus is a new highly contagious via human-to-human transmission. The median duration of viral shedding is 20.0 days. We report that the longest duration of viral shedding was 32.0 days from illness onset in a patient with moderate COVID-19 admitted to QianJiang Central Hospital.Case presentation: A 37-year-old male sought medical advice while suffering from fever, dry cough, fatigue, dizziness, runny nose and diarrhoea. Five days before the visit, he had a history of travel from affected geographic areas. The patient had a positive RT-PCR test, and chest CT images showed multiple nodules and mixed ground-glass opacification with consolidation in both lungs. Laboratory findings showed that his lymphocyte and CD4+ counts were below the normal range. The patient was given antiviral treatment, including arbidol, lopinavir, IFN-α, and traditional Chinese medicine, and other necessary support care. All clinical symptoms and CT imaging manifestation abnormalities resolved during the course of therapy.Conclusion: Although the positive RT-PCR tests were verified in consecutive upper respiratory specimens, the clinical symptoms, CT imaging findings, CD4+ lymphocyte counts, and IgG antibody levels had obviously improved. Positive tests may be detecting pieces of inactive viruses, which would not be transmissible in individual cases.

Immune response following infection with SARS‐CoV‐2 and other coronaviruses: A rapid review

“…Overall, 102 studies were identified that met our inclusion criteria, encompassing 6792 cases diagnosed by respiratory RT‐PCR testing (SARS‐CoV‐2, SARS‐CoV or MERS‐CoV). These included 92 case series/cohort studies, 5‐96 eight case reports 97‐104 and two cross‐sectional studies 105,106 …”