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. 2020 Jul;34(7):e23392.
doi: 10.1002/jcla.23392. Epub 2020 Jun 7.

Clinical features of COVID-19 convalescent patients with re-positive nucleic acid detection

Hui Zhu  1   2 , Liyun Fu  2   3 , Yinhua Jin  4 , Jiale Shao  5 , Shun Zhang  1   2 , Nanhong Zheng  6 , Lingyan Fan  6 , Zhe Yu  5 , Jun Ying  5 , Yaoren Hu  2   3 , Tongen Chen  7 , Yanglingzi Chen  1   2 , Min Chen  1   2 , Mingjue Chen  1   2 , Zi Xiong  1   2 , Junfei Kang  1   2 , Jiachang Jin  1   2 , Ting Cai  1   2 , Honghua Ye  8
Affiliations

Clinical features of COVID-19 convalescent patients with re-positive nucleic acid detection

Hui Zhu et al. J Clin Lab Anal. 2020 Jul.

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a pandemic that has rapidly spread worldwide. Increasingly, confirmed patients being discharged according to the current diagnosis and treatment protocols, follow-up of convalescent patients is important to knowing about the outcome.

Methods: A retrospective study was performed among 98 convalescent patients with COVID-19 in a single medical center. The clinical features of patients during their hospitalization and 2-week postdischarge quarantine were collected.

Results: Among the 98 COVID-19 convalescent patients, 17 (17.3%) were detected positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid during 2-week postdischarge quarantine. The median time from discharge to SARS-CoV-2 nucleic acid re-positive was 4 days (IQR, 3-8.5).The median time from symptoms onset to final respiratory SARS-CoV-2 detection of negative result was significantly longer in re-positive group (34 days [IQR, 29.5-42.5]) than in non-re-positive group (19 days [IQR, 16-26]). On the other hand, the levels of CD3-CD56 + NK cells during hospitalization and 2-week postdischarge were higher in re-positive group than in non-re-positive group (repeated measures ANOVA, P = .018). However, only one case in re-positive group showed exudative lesion recurrence in pulmonary computed tomography (CT) with recurred symptoms.

Conclusion: It is still possible for convalescent patients to show positive for SARS-CoV-2 nucleic acid detection, but most of the re-positive patients showed no deterioration in pulmonary CT findings. Continuous quarantine and close follow-up for convalescent patients are necessary to prevent possible relapse and spread of the disease to some extent.

Keywords: COVID-19; SARS-CoV-2; convalescent patients.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Chest CT findings of a 77‐y‐old woman with COVID‐19 pneumonia. The patient was hospitalized on February 2, 2020, after 3 d fever. Body temperature was normal and no other respiratory symptoms were observed during hospitalization. Positive RT‐PCR result of SARS‐Cov‐2 for sputum and pharyngeal swab specimens was first detected on February 5, 2020. A, Chest computed tomography (CT) on admission showed bilateral scattered patchy lesions under the pleura (February 2, 2020). B, After 7 d treatment, chest CT images showed substantial absorption of acute exudative lesions (February 9, 2020). Meanwhile, consecutive RT‐PCR tests of respiratory SARS‐Cov‐2 were negative on both February 9 and February 12, 2020. The patient was in postdischarge quarantine for further medical observation from February 12. C, Fever reappeared on February 24, 2020, and CT images demonstrated patchy lesions in upper lobe of bilateral lungs, especially in the left lung. RT‐PCR tests of SARS‐Cov‐2 for sputum and pharyngeal swab specimens were suspected positive on February 26, 2020, and the patient was re‐admitted for treatment (D) CT scan on February 28, 2020, showed lesions at upper lobe of bilateral lungs were almost absorbed. RT‐PCR tests for sputum and pharyngeal swab specimens were negative on February 29, 2020
FIGURE 2
FIGURE 2
The repeated measures of CD3‐CD56 + NK cell. Difference of CD3‐CD56 + NK cell between the positive group and the non‐positive group was tested using repeated measures two‐way analysis of variance with Greenhouse‐Geisser correction
See this image and copyright information in PMC

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