Abstract
There have been multiple reports of patients with coronavirus disease (COVID-19) testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after discharge; however, information on the characteristics of such cases is limited. In this case report, we aimed to identify clinical and epidemiological characteristics of patients who had a repeat positive polymerase chain reaction (PCR) test for SARS-CoV-2. We analyzed data of 22 COVID-19 patients who tested positive for SARS-CoV-2 on polymerase chain reaction (PCR) testing after two consecutive negative PCR results following discharge from hospitals. The interval between the two positive tests in the episodes of COVID-19 ranged from 4 to 117 days. More than one-third of the cases were healthcare workers (HCWs) and one-third of them had comorbidities. The main symptoms were cough and fever, and we noticed that males experienced more symptoms and signs of COVID-19 than females. Individuals with repeat SARS-CoV-2 positivity tend to experience milder illness during the second episode than the first episode. To confirm the reinfection of SARS-CoV-2, the results of other tests, such as viral culture and immunological assays of immunoglobulin G (IgG) and immunoglobulin M (IgM), need to be considered. Recovered COVID-19 patients should continue social distancing, using face masks, and practicing hand hygiene, especially HCWs who are more likely to be exposed to SARS-CoV-2.
Highlights
On 31 December 2019, the World Health Organization (WHO, Geneva, Switzerland)Country Office in China reported a case of pneumonia of unknown cause in Wuhan, China
Another study conducted by Lan et al in Wuhan, China, reported about four medical professionals who tested positive for SARS-CoV-2 on RT-polymerase chain reaction (PCR) tests 5–13 days after recovery, and suggested that some recovered patients may remain convalescent carriers [10]
This study illustrates that many patients who have recovered from COVID-19 have repeat positive PCR tests for SARS-CoV-2 after having negative results with or without symptoms
Summary
On 31 December 2019, the World Health Organization (WHO, Geneva, Switzerland)Country Office in China reported a case of pneumonia of unknown cause in Wuhan, China. The new disease was subsequently named coronavirus disease (COVID-19), and the causative virus was identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. COVID-19 spread rapidly worldwide and became a pandemic. As of 10 December 2021, over 267 million confirmed cases and over 5 million deaths in 216 countries have been reported to the WHO, and the number of cases is still rapidly increasing [2]. In the Kingdom of Saudi Arabia (KSA), patients with COVID-19 who require admission to hospitals are discharged after they have been asymptomatic for more than three days and have at least two consecutive negative SARS-CoV-2 results on real-time polymerase chain reaction (RT-PCR) tests [3]. The clinical course and laboratory results of patients who have repeat positive tests for SARS-CoV-2 have not been well-documented.
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