Patrocínio de Jesus Rita, Silva Raquel, Aliyeva Elzara, Lopes Luís, Portugalyan Mihran, Antunes Liliana, Diaz Priscila, Costa Carolina, Araújo Ana Carolina, Coelho Sílvia, Mendes João João, Gomes Sara, Serra Isabel, Freitas Paulo
Department of Infectious Diseases, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.
Department of Intensive Care, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.
SN Compr Clin Med. 2020;2(11):2402-2405. doi: 10.1007/s42399-020-00548-x. Epub 2020 Oct 2.
As SARS-CoV-2 and its related clinical syndrome (COVID-19) became a pandemic worldwide, questions regarding its clinical presentation, infectivity, and immune response have been the subject of investigation. We present a case of a patient previously considered recovered from nosocomially transmitted asymptomatic COVID-19 illness, who presented with new respiratory, radiological, and RT-PCR findings consistent with COVID-19, while on high-dose prednisolone due to a suspected secondary demyelinating disease. Importantly, it led to three subsequent cases within patient's household after discharge from the hospital. After reviewing this case in light of current evidence and debates surrounding SARS-CoV-2 RT-PCR results, we hypothesize that patients on corticosteroids may have particular viral shedding dynamics and should prompt a more conservative approach in regard to isolation discontinuation and monitoring.
随着严重急性呼吸综合征冠状病毒2（SARS-CoV-2）及其相关临床综合征（新冠肺炎）在全球范围内大流行，关于其临床表现、传染性和免疫反应的问题一直是研究的主题。我们报告一例患者，该患者曾被认为已从医院获得性无症状新冠肺炎疾病中康复，因疑似继发性脱髓鞘疾病而接受大剂量泼尼松龙治疗时，出现了与新冠肺炎一致的新的呼吸道、影像学和逆转录聚合酶链反应（RT-PCR）结果。重要的是，该患者出院后导致其家庭中随后出现了三例病例。根据目前围绕SARS-CoV-2 RT-PCR结果的证据和争论对该病例进行回顾后，我们推测使用皮质类固醇的患者可能具有特殊的病毒脱落动态，在停止隔离和监测方面应采取更保守的方法。
