Re-emergence of SARS-CoV2 in a discharged COVID-19 case

Zhou, Mei; Li, Qingfeng; Cao, Lin; Ying-fen, Liu; Zha, Yi; He, Xie; Zeng, Mingquan; Shi, Xuemei; Gao, Yueqing; Xie, Liqiu; Luo, Moulun; Zeng, Yilan

doi:10.1016/j.jmii.2020.03.031

Cited by 5 publications

(6 citation statements)

References 3 publications

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“…All 7 RP patients had shorter hospital stays, lower medical costs, and milder symptoms in their second hospital visit than in their first hospitalization. Nonorganic insomnia and increased anxiety were observed in 2 RP patients Li et al [32] China Case report – 1 50 1/- – positive – – positive Patient was asymptomatic, chest CT scans showed improvement of original lesions, with only a few GGOs Zhou et al [57] China Case report 1 – 40 1/- 10 d positive – – – Patient presented with chest pain and cough with sputum production. Chest CT scan showed absorption of lung disease Liu et al [38] China Case report – 1 35 1/- 15 d positive negative – IgG positive Chest CT imaging showed new lesions in the upper left lung.…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta-analysis of discharged COVID-19 patients retesting positive for RT-PCR

Ren

Lou

et al. 2021

EClinicalMedicine

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Background With the increased number of patients discharged after having COVID-19, more and more studies have reported cases whose retesting was positive (RP) during the convalescent period, which brings a new public health challenge to the world. Methods We searched PubMed, Web of Science, The Cochrane Library, CNKI, WanFang and VIP from December 1, 2019 to December 31, 2020. The included studies were assessed using JBI critical appraisal tools and Newcastle-Ottawa Scale. The RP rate of discharge patients was analyzed by a meta-analysis. We adhered to PRISMA reporting guideline. Findings We have included 117 studies with 2669 RP participants after discharge. The methodological quality of 66 case reports were low to high, 42 case series and 3 cohort study were moderate to high, 3 case-control studies were moderate and 3 cross-sectional studies were low to moderate. The clinical manifestations of most RP patients were mild or asymptomatic, and CT imaging and laboratory examinations were usually normal. The existing risk factors suggest that more attention should be paid to sever patients, elderly patients, and patients with co-morbidities. The summary RP rate was 12·2% (95% CI 10·6–13·7) with high heterogeneity ( I 2 = 85%). Interpretation To date, the causes and risk factors of RP result in discharged patients are not fully understood. High-quality etiological and clinical studies are needed to investigate these issues to further help us to make strategies to control and prevent its occurrence.

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Section: Resultsmentioning

confidence: 99%

A systematic review and meta-analysis of discharged COVID-19 patients retesting positive for RT-PCR

Ren

Lou

et al. 2021

EClinicalMedicine

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“…As the incidence of recurrent COVID-19 positive was reported by approximately 14.8%, the study by Azam [ 35 ] estimated the time from the last negative to the recurrent positive result by 9.8 days (95% CI 7.31–12.22). Despite the insufficient time for patients to accumulate enough virus for nasopharyngeal RT-PCR test, other factors including inappropriate sampling procedures and low sensitivity of test facilities may also result in temporarily negative test [ 36 , 37 ]. In this study, 30.8% of total 55 times recurrent positive events occurred beyond 14-days isolation, and the longest time of virus shedding is 66 days after the first admission to hospital.…”

Section: Discussionmentioning

confidence: 99%

Demand for longer quarantine period among common and uncommon COVID-19 infections: a scoping review

Peng

Gao

et al. 2021

Infect Dis Poverty

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Background As one of the non-pharmacological interventions to control the transmission of COVID-19, determining the quarantine duration is mainly based on the accurate estimates of the incubation period. However, patients with coarse information of the exposure date, as well as infections other than the symptomatic, were not taken into account in previously published studies. Thus, by using the statistical method dealing with the interval-censored data, we assessed the quarantine duration for both common and uncommon infections. The latter type includes the presymptomatic, the asymptomatic and the recurrent test positive patients. Methods As of 10 December 2020, information on cases have been collected from the English and Chinese databases, including Pubmed, Google scholar, CNKI (China National Knowledge Infrastructure) and Wanfang. Official websites and medias were also searched as data sources. All data were transformed into doubly interval-censored and the accelerated failure time model was applied. By estimating the incubation period and the time-to-event distribution of worldwide COVID-19 patients, we obtain the large percentiles for determining and suggesting the quarantine policies. For symptomatic and presymptomatic COVID-19 patients, the incubation time is the duration from exposure to symptom onset. For the asymptomatic, we substitute the date of first positive result of nucleic acid testing for that of symptom onset. Furthermore, the time from hospital discharge or getting negative test result to the positive recurrence has been calculated for recurrent positive patients. Results A total of 1920 laboratory confirmed COVID-19 cases were included. Among all uncommon infections, 34.1% (n = 55) of them developed symptoms or were identified beyond fourteen days. Based on all collected cases, the 95th and 99th percentiles were estimated to be 16.2 days (95% CI 15.5–17.0) and 22.9 days (21.7‒24.3) respectively. Besides, we got similar estimates based on merely symptomatic and presymptomatic infections as 15.1 days (14.4‒15.7) and 21.1 days (20.0‒22.2). Conclusions There are a certain number of infected people who require longer quarantine duration. Our findings well support the current practice of the extended active monitoring. To further prevent possible transmissions induced and facilitated by such infectious outliers after the 14-days quarantine, properly prolonging the quarantine duration could be prudent for high-risk scenarios and in regions with insufficient test resources.

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“…Another reason as reviewed could be that the convalescing COVID -19 patients may not have built enough anti bodies or built up immunity to SARS-CoV-2 and thus become infected again. It could also be that the virus is biphasic like anthrax which entails the virus lying dormant before developing new symptoms (Zhou et al, 2020). Be it as it may, it is still unclear whether the second positive result of a treated COVID-19 patient can be linked to transmission of the infection to other persons.…”

Section: Reasons For Covid-19 Re-infection Among Recovered Patientsmentioning

confidence: 99%

“…Be it as it may, it is still unclear whether the second positive result of a treated COVID-19 patient can be linked to transmission of the infection to other persons. However, given to the disastrous outcome of imminent disease transmission, longer observation period ought to be taken into consideration for COVID-19 patients (Zhou et al, 2020).…”

Section: Reasons For Covid-19 Re-infection Among Recovered Patientsmentioning

confidence: 99%

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Review of COVID-19 Re-Infection among Recovered Patients and Its Implication for Lung Health

Obande-Ogbuinya¹,

Omaka-Amari²,

Nwafor³

et al. 2020

GJHS

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COVID-19 infection has continued to pose a very serious health threat to mankind globally despite all efforts geared toward curbing its spread. More worrisome recently is the report from different parts of the world on the re-infection of those treated and recovered with COVID -19 patients thus making containment of the virus even more difficult. Of more worrisome is the fact that the lung, a vital human organ is a major site being attacked by the virus even on re-infection cases. If quick action is not taken early enough, it may lead to the outright death of the patient. A lung infection, (Pneumonia) caused by COVID-19 has been discovered to be having a stunning effect on hospital systems and killing COVID-19 patients silently and it occurs even as the patient is asymptomatic. This paper examines the reasons for re-infection, Lacuna in the reviewed literature with regards to PCR test results, the effect of re-infection on the lungs, and implication for patients’ lung health. The papers summarized and concluded that it’s a fact that re-infection occurs among patients accompanied by mild or severe symptoms having far-reaching implications for the patient’s lung health. The paper recommends that the government at all levels should collaborate with WHO, CDC, and health policymakers to legally mandating, that every recovered patient should stay an additional 2weeks in the hospital for early detection of re-infection in order to avert any invasion and damage to the lungs thus ensuring lung health. Also, proper health education should be availed to the recovered patients to avoid any exposures or habits (different from the index disease) such as smoking that can pose dangers to the already fatigued lungs.

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Re-emergence of SARS-CoV2 in a discharged COVID-19 case

Cited by 5 publications

References 3 publications

A systematic review and meta-analysis of discharged COVID-19 patients retesting positive for RT-PCR

A systematic review and meta-analysis of discharged COVID-19 patients retesting positive for RT-PCR

Demand for longer quarantine period among common and uncommon COVID-19 infections: a scoping review

Review of COVID-19 Re-Infection among Recovered Patients and Its Implication for Lung Health

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