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再感染、复发还是 COVID-19 的延迟表现?病例系列和文献复习。

Reinfection, recurrence, or delayed presentation of COVID-19? Case series and review of the literature.

机构信息

Internal Medicine Department, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia.

Internal Medicine Department, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia.

出版信息

J Infect Public Health. 2021 Apr;14(4):474-477. doi: 10.1016/j.jiph.2021.01.002. Epub 2021 Jan 14.

Abstract

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-cov-2), first described in December 2019, has now infected more than 28 million cases with almost one million deaths. Reinfection is not definitely established however disease recurrence is increasingly reported.

CASES PRESENTATION

Four patients presented with a second episode of coronavirus disease 2019 (COVID-19) occurring 27-85 following their first illness. The initial episode was mild or asymptomatic while the second attack was severe requiring hospital admission. All four patients had a SARS-CoV-2 PCR test positive in the second episode. The chest-X-ray and/or computerized tomography (CT) scan showed bilateral alveolar shadows. Furthermore, the inflammatory markers were raised in the four patients. Three patients recovered following treatment with favipravir in addition tocilizumab and/or dexamethasone.

CONCLUSION

Covid19 reinfection Recurrent COVID-19 is increasingly reported. However; other etiologies including superadded infection or pulmonary embolism should be ruled out, particularly if recurrence occurs less than 3 weeks.

摘要

背景

严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)于 2019 年 12 月首次描述,现已感染超过 2800 万人,近百万人死亡。然而,目前尚未明确再次感染的情况,但疾病复发的报道越来越多。

病例介绍

4 名患者在首次发病后 27-85 天出现了第二次冠状病毒病 2019(COVID-19)发作。初次发作时症状较轻或无症状,而第二次发作则较为严重,需要住院治疗。这 4 名患者的第二次发作中均检测到 SARS-CoV-2 PCR 阳性。胸部 X 光和/或计算机断层扫描(CT)显示双侧肺泡阴影。此外,这 4 名患者的炎症标志物均升高。除了托珠单抗和/或地塞米松外,3 名患者还接受了法匹拉韦治疗后康复。

结论

COVID-19 再次感染,COVID-19 复发的报道越来越多。然而,其他病因,包括合并感染或肺栓塞等,应予以排除,特别是如果复发发生在 3 周内。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fcc/7834000/223b2961705d/gr1_lrg.jpg

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