COVID-19 Patients May Retest Positive After Recovery With No Symptoms

By Reuters Staff

July 15, 2020

NEW YORK (Reuters Health) - Some COVID-19 patients have tested positive for SARS-CoV-2 after they recover, raising the risk of further spread of the virus, say clinicians in Wuhan, China.

To prevent a second wave of COVID-19 infections, they recommend a minimum period of 14-day clinical observation in medical "shelters" following recovery from COVID-19.

In a Comment in The Lancet Infectious Diseases, they report on 651 patients from the Wuhan Pulmonary Hospital who were classified as recovered from COVID-19 and discharged into intermediary shelter hospitals or other health centers for 14-day clinical monitoring.

To be discharged, the patients had to be hemodynamically stable and afebrile for more than three days; have radiological evidence of substantial resolution of pneumonia on CT scan; two negative SARS-CoV-2 PCR tests at least one day apart; and no concurrent acute medical issues requiring transfer to another medical facility.

During median follow-up of 48 days, 23 (3%) of the patients tested positive on a retest for SARS-CoV-2 in a routine health check. The median time from hospital discharge to a positive retest was 15 days and from a positive retest to hospital readmission, 1.5 days.

The 23 retest-positive patients had a median age of 56 years; 12 were women and 11 men. Twelve (52%) patients had moderate, nine (39%) severe, and two (9%) critical conditions during their index hospitalization.

Fifteen retest-positive patients (65%) had no symptoms at the time of the retest and eight (35%) had at least one symptom associated with active COVID-19; six (26%) presented with fever, two (9%) had a cough, one (4%) had fatigue, one (4%) dyspnea, and one (4%) chest tightness.

"Although a positive PCR test in asymptomatic patients who were retested might only reflect residual non-pathogenic viral components, the positive retest in symptomatic patients suggests the potential for recurrence of active disease and its transmission," Dr. Xianglin Yuan of Wuhan's Tongji Hospital and colleagues note in their article.

It's also noteworthy, they say, that 52% of retest-positive patients had IgG antiviral antibodies and 30% had IgM antibodies, which suggests partial immune system recognition of SARS-CoV-2.

"Because 35% of patients with a positive retest had one or more COVID-19-related symptoms, the usefulness of viral antibodies in COVID-19 clearance remains in question, and the potential for continued virus transmission after hospital discharge warrants additional investigation," they write.

Dr. Yuan did not respond to a request for comment by press time.

SOURCE: https://bit.ly/2ZumMWV Lancet Infectious Diseases, online July 6, 2020.

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