Baiswar Shalanki, Mittal Rea, Tiwary Tarkeshwar, Jinnur Praveen
Internal Medicine, WellSpan Health, Chambersburg, USA.
Neurology, Penn State College of Medicine, Hershey, USA.
Cureus. 2021 Jun 22;13(6):e15825. doi: 10.7759/cureus.15825. eCollection 2021 Jun.
The coronavirus disease 2019 ( COVID-19) pandemic is a global pandemic where healthcare providers are concerned about the reinfection of recovered patients. The reinfection with COVID-19 is not common and considered less likely, but as time passes by, there are reports of patients becoming positive after having tested negative previously. Here, we report a case of a 28-year-old male with diabetes mellitus type 1, hypertension, and end-stage renal disease on hemodialysis who presented initially in April 2020 with nausea, vomiting, and dyspnea. His severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) came back positive. He left against medical advice but was followed as an outpatient in the dialysis unit where he continued with dialysis in isolation for positive COVID-19 as per the dialysis unit guidelines. He presented three months later with altered level of consciousness in the setting of diabetic ketoacidosis. He also had gastrointestinal bleed and cerebrovascular accident. There was a strong possibility of reinfection in this patient as he was tested negative after the initial infection and then tested positive three months later, presenting with a different set of symptoms and more severe disease on his second admission.
2019年冠状病毒病（COVID-19）大流行是一场全球大流行，医疗保健提供者担心康复患者会再次感染。COVID-19再次感染并不常见，且被认为可能性较小，但随着时间的推移，有报道称患者在之前检测呈阴性后又转为阳性。在此，我们报告一例28岁男性病例，该患者患有1型糖尿病、高血压和终末期肾病，正在接受血液透析，于2020年4月首次出现恶心、呕吐和呼吸困难症状。他的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）聚合酶链反应（PCR）检测结果呈阳性。他自行离院，但作为门诊患者在透析单元接受随访，按照透析单元指南，他在隔离状态下继续进行透析，因为他的COVID-19检测呈阳性。三个月后，他在糖尿病酮症酸中毒的情况下出现意识水平改变。他还出现了胃肠道出血和脑血管意外。该患者很有可能再次感染，因为他在初次感染后检测呈阴性，三个月后检测又呈阳性，第二次入院时出现了不同的症状且病情更严重。
