Department of Emergency Medicine, Massachusetts General Hospital, Harvard Affiliated Emergency Medicine Residency, Boston, MA, USA.
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Am J Emerg Med. 2021 Jan;39:256.e1-256.e3. doi: 10.1016/j.ajem.2020.06.079. Epub 2020 Jul 4.
Since December 2019, COVID-19, the clinical syndrome associated with SARS-CoV-2 infection, has infected more than 6.2 million people and brought the function of the global community to a halt. As the number of patients recovered from COVID-19 rises and the world transitions toward reopening, the question of acquired immunity versus the possibility of reinfection are critical to anticipating future viral spread. Here, we present a case of a patient previously recovered from COVID-19 who re-presents with new respiratory, radiographical, laboratory, and real-time reverse transcriptase-polymerase chain reaction (RT-PCR) findings concerning for possible re-infection. We review this case in the context of the evolving discussion and theories surrounding dynamic RT-PCR results, prolonged viral shedding, and the possibility of developed immunity. Understanding how to interpret dynamic and late-positive SARS-CoV-2 RT-PCR results after primary infection will be critical for understanding disease prevalence and spread among communities worldwide.
自 2019 年 12 月以来,与 SARS-CoV-2 感染相关的临床综合征 COVID-19 已感染了超过 620 万人,并使全球社会的功能陷入停顿。随着 COVID-19 患者康复人数的增加以及世界向重新开放的方向发展,获得性免疫与再次感染的可能性这两个问题对于预测未来病毒传播至关重要。在这里,我们报告了一例先前从 COVID-19 中康复的患者,其出现了新的呼吸道、影像学、实验室和实时逆转录-聚合酶链反应(RT-PCR)结果,提示可能再次感染。我们在围绕动态 RT-PCR 结果、病毒延长排出和免疫建立的可能性的不断发展的讨论和理论背景下审查了这一病例。了解如何解释初次感染后 SARS-CoV-2 RT-PCR 结果的动态和晚期阳性,对于理解全球社区中的疾病流行和传播至关重要。