What are the Clinical Implications of a Positive RT-PCR Test 6 Months after a Mild SARS-CoV-2 Infection?
What are the Clinical Implications of a Positive RT-PCR Test 6 Months after a Mild SARS-CoV-2 Infection?
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DOI：
10.12890/2021_002463
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发表时间：
2021-01-01
影响因子：
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通讯作者：
Hvozdara, Kateryna
中科院分区：
文献类型：
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作者：
De Carvalho, Joao Gabriel;Hvozdara, Kateryna
我们介绍了一名84岁女性患者因髋部骨折住院接受手术治疗的病例，该患者在2020年4月出现轻微呼吸道症状并确诊COVID-19后约6个月，经RT-PCR鼻咽拭子重新检测SARS-CoV-2呈阳性。我们讨论了再感染的可能性、长期病毒脱落和残留阳性、RT-PCR拭子检测的局限性，以及随着COVID-19大流行的蔓延和持久免疫力的不确定性，新检测方法的必要性。学习要点：该病例表明，患者在上一次COVID-19后长达6个月的时间内，仍可能在标准RT-PCR鼻咽拭子检测中检测出阳性。可行的病毒脱落可能与COVID-19的严重程度以及COVID-19后持续的肺间质损伤有关。如果再感染变得常见，则可能需要新的检测方法，因为使用标准RT-PCR拭子检测已知既往COVID-19的患者可能导致假阳性诊断。
We present the case of an 84-year-old female patient hospitalized for surgical treatment of a hip fracture who re-tested positive for SARS-CoV-2 with an RT-PCR nasopharyngeal swab approximately 6 months after presenting mild respiratory symptoms with confirmed COVID-19 in April 2020. We discuss the possibility of reinfection, long-term viral shedding and residual positivity, the limitations of RT-PCR swab tests, and the necessity for new testing methods as the COVID-19 pandemic spreads and long-lasting immunity is uncertain.LEARNING POINTS: This case suggests that a patient could still test positive on a standard RT-PCR nasopharyngeal swab test for as long as 6 months after previous COVID-19.Long-term non-viable viral shedding may be related to the severity of COVID-19 and to persistent pulmonary interstitial damage after COVID-19.New testing methods may be required if reinfection becomes common, as testing a patient with known past COVID-19 using a standard RT-PCR swab test could lead to a false positive diagnosis.