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J Biomed Res . An unusual COVID-19 case with over four months of viral shedding in the presence of low neutralizing antibodies: a case report

tetano

Editor, Senior Moderator
J Biomed Res


. 2020 Sep 16;34(6):470-474.
doi: 10.7555/JBR.34.20200099.
An unusual COVID-19 case with over four months of viral shedding in the presence of low neutralizing antibodies: a case report


Wei Chen[SUP] 1 [/SUP], Zhiliang Hu[SUP] 2 [/SUP], Changhua Yi, Yun Chi, Qingfang Xiong, Chee Wah Tan[SUP] 3 [/SUP], Yongxiang Yi, Lin-Fa Wang[SUP] 3 [/SUP]



Affiliations

Abstract

The ongoing coronavirus disease 2019 (COVID-19) pandemic is a global public health crisis, causing social and economic disasters in many countries. In China, two-consecutive negative results of nucleic acid tests for SARS-CoV-2 from the respiratory samples are required to end the quarantine of COVID-19 patients. However, clinicians face a dilemma in case of patients with long-term viral shedding. This report described an unusual COVID-19 case who had persistent viral RNA positivity for more than 4 months after initial illness in the presence of low neutralizing antibodies, but without prolonged clinical symptoms. Multiple anti-viral drug treatments had no impact and there was no evidence of re-infection. When the patient was self-quarantined at home, no infection occurred to the three family members living with her for 15 to 19 days. Sputum viral culture in BSL-3 laboratory on the 102 [SUP]nd[/SUP] day after symptom onset was negative. From the 129 [SUP]th[/SUP] day on, 8 continuous nucleic acid tests of sputum samples showed negative results. The patient was discharged on 137 [SUP]th[/SUP] days since symptom onset. In conclusion, viral RNA shedding in the sputum of the COVID-19 patient may last over 4 months. As no evidence shows the existence of infectious virus, two-consecutive negative nucleic acid tests may not be the prerequisite for ending quarantine of COVID-19 patients with prolonged viral shedding.

Keywords: COVID-19; SARS-CoV-2; neutralizing antibodies; quarantine; viral shedding.
 
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