Persistent viral shedding lasting over 60 days in a mild COVID-19 patient with ongoing positive SARS-CoV-2

Zhang, Lan; Li, Changbo; Zhou, Yanru; Wang, Binjie; Zhang, Jiajia

doi:10.21037/qims.2020.04.08

Cited by 18 publications

(19 citation statements)

References 4 publications

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“…Understanding the kinetics of infectious viral shedding in relation to possible transmission risk is crucial to guide infection prevention and control strategies ( Anderson et al, 2004 ), even if the correlation between infectivity and viral persistence is still unclear ( Widders et al, 2020 ). Long-term shedding of viral RNA has been reported in COVID-19 patients putting serious problems on timely discharge from hospital or home isolation ( Wölfel et al, 2020 , Zhang et al, 2020 ) in order to mitigate the risk of secondary community transmission. Although this topic is currently under consideration in SARS-CoV-2 infection ( Kampen et al, 2020 ), only few studies investigating factors possibly influencing the viral shedding duration have been performed so far, with conflicting results.…”

Section: Introductionmentioning

confidence: 99%

Determinants of prolonged viral RNA shedding in hospitalized patients with SARS-CoV-2 infection

Dezza

Oliva

Cancelli

et al. 2021

Diagnostic Microbiology and Infectious Disease

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Objective To evaluate determinants of prolonged viral RNA shedding in hospitalized patients with SARS-CoV-2 infection. Materials and methods Hospitalized patients with SARS-CoV-2 positive nasopharyngeal RT-PCR were included in a single-center, retrospective study. Patients were divided in two groups according to the timing of viral clearance [≤14 days, “early clearance (EC)” and >14 days, “late clearance (LC)”]. Results 179 patients were included in the study (101 EC, 78 LC), with median age 62 years. Median time of viral shedding was 14 days (EC/LC 10 and 19 days, respectively, p<0.0001). Univariate analyses showed that age, male gender, receiving corticosteroids, receiving tocilizumab, ICU admission, low albumin and NLR ratio were associated with late viral clearance. In the multivariable analysis, older age (p=0.016), albumin level (p=0.048), corticosteroids (p=0.021) and tocilizumab (p=0.015) were significantly associated with late viral clearance. Conclusions Age, albumin, tocilizumab and corticosteroid treatment were independently associated with a prolonged SARS-CoV-2 RNA shedding.

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Section: Introductionmentioning

confidence: 99%

Determinants of prolonged viral RNA shedding in hospitalized patients with SARS-CoV-2 infection

Dezza

Oliva

Cancelli

et al. 2021

Diagnostic Microbiology and Infectious Disease

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“… 14 The longest reported viral shedding is 60 days in a 47-year-old woman including her symptomatic course and ongoing recovery. 15 To our knowledge, our case of viral shedding for 36 days is the longest reported in a relatively young, asymptomatic patient or in a patient with a VP shunt demonstrating a VP shunt as a possible predisposition for prolonged viral shedding and possible asymptomatic infectivity. However, further studies and case reports are needed to draw this conclusion.…”

Section: Discussionmentioning

confidence: 65%

Prolonged RNA shedding of the 2019 novel coronavirus in an asymptomatic patient with a VP shunt

2020

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A 33-year-old man with paranoid schizophrenia and a ventriculoperitoneal (VP) shunt was sent to our institution from an inpatient psychiatric facility due to concerns for the 2019 novel coronavirus (COVID-19). Per the facility, the patient had a fever and non-productive cough. On admission, the patient was afebrile and lacked subjective symptoms. A RNA reverse transcriptase PCR (RNA RT-PCR) test for COVID-19 was positive. A chest X-ray contained a small patchy opacity in the right middle lobe and another in the retrocardiac region concerning for pneumonia. Inflammatory markers were mildly elevated. He remained COVID-19 positive and asymptomatic for 36 days. This case details one asymptomatic carrier’s course with persistently positive COVID-19 nasopharyngeal swabs. It demonstrates that a VP shunt could be a possible predisposition for prolonged viral shedding.

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“…Nevertheless, the longest record was 60 days after onset. [21][22][23][24][25] Most treatments for COVID- 19 as zinc administration, because probiotics can block or inactivate RdRp so it will prevent virus replication. [26][27][28][29][30][31] Since COVID-19 was a novel disease, there was not any patent guideline.…”

Section: Shortness Of Breath Nausea Diarrheamentioning

confidence: 99%

The First Case of COVID-19 in South Kalimantan

Nor

Haryati

2020

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Background: In December 2019, a series of acute respiratory syndromes occurred in Wuhan, China. This syndrome became known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The sudden appearance and rapid global spread of SARS-CoV-2 led World Health Organization (WHO) to declare it as a pandemic disease on March 11, 2020. We will report the first case COVID-19 in South Kalimantan.Case: A 44-year-old man was presented with fever, 7 days before admission. The patient also complained about cough with white phlegm and shortness of breath, accompanied by nausea with heartburn and decreased of appetite. He confessed that he just returned from local transmission areas of COVID-19. From physical examination, it was found SaO2 92% room air with bronchial sounds and ronchi in the lung. Chest X-ray showed peripheral infiltrates and diagnostic swab with RT-PCR in the oropharynx and nasopharynx showed that the patient was infected with SARS-CoV-2. HbsAg marker on this patient was also reactive. The patient then received supportive therapy as well as antiviral therapy. After 10 days of treatment, the patient was already free from the symptom, but swab evaluation remained positive. On the 31st day of treatment, the patient was finally declared cured with a negative swab result.Conclusion: The number of COVID-19 cases has increased from time to time. Holistic treatment and rapid detection greatly affect the prognosis of this disease. Prevention through health protocols is also very important to reduce its spread.

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Persistent viral shedding lasting over 60 days in a mild COVID-19 patient with ongoing positive SARS-CoV-2

Abstract: This study was approved by the local institutional review board. Written informed consent was obtained from the patient for publication of this study and any accompanying images.

Cited by 18 publications

References 4 publications

Determinants of prolonged viral RNA shedding in hospitalized patients with SARS-CoV-2 infection

Determinants of prolonged viral RNA shedding in hospitalized patients with SARS-CoV-2 infection

Prolonged RNA shedding of the 2019 novel coronavirus in an asymptomatic patient with a VP shunt

The First Case of COVID-19 in South Kalimantan

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