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

Jessica Tuan, Anne Spichler-Moffarah, Onyema Ogbuagu
Author Information
  1. Jessica Tuan: Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, USA Jessica.Tuan@Yale.Edu. ORCID
  2. Anne Spichler-Moffarah: Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, USA.
  3. Onyema Ogbuagu: Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, USA.

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

References

  1. Clin Infect Dis. 2020 Nov 19;71(16):2027-2034 [PMID: 32221519]
  2. EBioMedicine. 2020 Sep;59:102960 [PMID: 32853988]
  3. Nat Med. 2020 Jun;26(6):845-848 [PMID: 32350462]
  4. Nature. 2020 May;581(7809):465-469 [PMID: 32235945]
  5. J Gen Virol. 2020 Aug;101(8):791-797 [PMID: 32430094]
  6. Nat Med. 2020 May;26(5):672-675 [PMID: 32296168]
  7. Nat Commun. 2020 Sep 17;11(1):4704 [PMID: 32943637]
  8. Infect Dis Health. 2020 Aug;25(3):210-215 [PMID: 32473952]
  9. Clin Infect Dis. 2021 Nov 2;73(9):e2946-e2951 [PMID: 32840608]
  10. Ann Transl Med. 2020 Sep;8(17):1084 [PMID: 33145303]

Grants

  1. UL1 TR001863/NCATS NIH HHS

MeSH Term

Adult
Antibodies, Monoclonal, Humanized
COVID-19
Humans
Intensive Care Units
Male
RNA, Viral
Radiography
Reinfection
SARS-CoV-2
Treatment Outcome
Virus Shedding

Chemicals

Antibodies, Monoclonal, Humanized
RNA, Viral
tocilizumab

Word Cloud

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