Fong Brandon, London Kory S
Thomas Jefferson University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania.
Clin Pract Cases Emerg Med. 2020 Nov;4(4):509-512. doi: 10.5811/cpcem.2020.7.49005.
The literature on the clinical course of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) suggests patients continue shedding viral particles typically for an average of 20 days until the body builds immunity against the infection. However, a few cases have shown prolonged duration in viral shedding and highlight the significant increased mortality in these patients. It has also been suggested that multiple strains of SARS-COV-2 exist, keying the possibility to reinfection.
We present a case of a 57-year-old male who presented twice over 37 days with symptoms related to SARS-COV-2, and only on his second visit was found to be in hypoxemic respiratory failure and cardiogenic shock. He also reportedly had a period of convalescence in between presentations.
This case highlights the still unclear disease course of SARS-COV-2 and the need for diligence in providing strong follow-up instructions and evaluation for sequelae of the infection.
关于严重急性呼吸综合征冠状病毒2（SARS-CoV-2）临床病程的文献表明，患者通常会持续排出病毒颗粒，平均持续20天，直到身体对感染产生免疫力。然而，少数病例显示病毒排出持续时间延长，并突出了这些患者死亡率的显著增加。也有人提出存在多种SARS-CoV-2毒株，这增加了再次感染的可能性。
我们报告一例57岁男性病例，该患者在37天内两次出现与SARS-CoV-2相关的症状，仅在第二次就诊时被发现处于低氧性呼吸衰竭和心源性休克状态。据报道，两次就诊之间他有一段恢复期。
该病例突出了SARS-CoV-2仍不清楚的疾病病程，以及在提供强有力的随访指导和评估感染后遗症方面保持勤勉的必要性。
