SARS-CoV-2 re-infection versus prolonged shedding: A case series

Abstract

Since the start of the SARS-CoV-2 pandemic, it has been difficult to differentiate between SARS-CoV-2 re-infection and prolonged RNA shedding. In this report, we identified patients with positive RT-PCR results for SARS-CoV-2 ≥70 days apart. Clinical and laboratory data were collected and criteria were applied to discern whether the presentation was consistent with SARS-CoV-2 re-infection or prolonged viral RNA shedding. Eleven individuals met the initial testing criteria, of which, seven met at least one criteria for re-infection and four were consistent with prolonged RNA shedding. These data demonstrate the need for criteria to differentiate SARS-CoV-2 re-infection from prolonged RNA shedding.

Keywords: SARS-CoV-2; re-infection; shedding.

FIGURE 1

This figure represents the longitudinal SARS‐CoV‐2 RT‐PCR data obtained for our 11 patients included in the cohort. The x‐axis defines the days since the start of symptoms for each patient. The y‐axis provides the patient number. The black boxes represent a positive RT‐PCR test for SARS‐CoV‐2, the white boxes represent a negative RT‐PCR test for SARS‐CoV‐2, and the hashed boxes represent an indeterminate RT‐PCR test for SARS‐CoV‐2. The cycle threshold values are listed for each positive sample within the black box. The red box represents those with probable SARS‐CoV‐2 re‐infection and the blue line represents the 70‐day cutoff for inclusion in the study