Assessment of #SARS-CoV-2 RNA Test Results Among Patients Who Recovered From COVID-19 With Prior Negative Results | Infectious Diseases | JAMA Internal Medicine | JAMA Network
▻https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2773053
Parmi 176 personnes guéries du #COVID-19, le PCR est redevenu positif après un délai moyen de 48.6 jours chez 32 (18%), alors qu’ils étaient tous sauf 1 restés asymptomatiques.
Une activité de réplication a été recherchée chez ces « re-positifs » et n’a été mise en évidence que chez la personne symptomatique (16 jours après la guérison, 39 jours après le diagnostic initial).
Discussion
Similar to that reported elsewhere,2 18% of patients with COVID-19 in our institution became RT-PCR positive for SARS-CoV-2 RNA after clinical recovery and previous negative results.5 As positivity in the patients was suggestive, but not necessarily a reflection, of viral carriage, we used replicative SARS-CoV-2 RNA detection as a proxy for virus replication in culture.4
Only 1 of 32 patients retesting positive had replicating virus in the NOS sample, suggesting either recurrent infection or reinfection, which is impossible to separate because no whole-genome sequencing and phylogenetic analyses were performed.3 The patient retested positive 16 days after COVID-19 recovery (ie, 39 days from COVID-19 diagnosis) and was symptomatic. The patient was an older adult with hypertension, diabetes, and cardiovascular disease but no evidence of close contacts with people with SARS-CoV-2 infection or persons who became RT-PCR positive. In the 31 remaining patients (who were asymptomatic), their positive result likely represented either recurrent or resolving infection, but in either case, they were unlikely to be infectious. The limitations of our study are the lack of data from viral cultures or whole-genome sequencing analysis and the small sample size.
Conclusions
This study highlights that many patients who recovered from COVID-19 may be still positive (albeit at lower levels) for SARS-CoV-2 RNA, but only a minority of the patients may carry a replicating SARS-CoV-2 in the respiratory tract. Further studies are needed to verify whether such patients can transmit the virus.
