Department of Internal Diseases, Pneumonology and Allergology, Medical University of Wrocław, Wrocław, Poland.
Department of Paediatrics, Allergology and Cardiology, Medical University of Wrocław, Wrocław, Poland.
Am J Case Rep. 2022 Feb 14;23:e935414. doi: 10.12659/AJCR.935414.
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is becoming challenging for public health crisis management. Effective detection method such as the criterion standard real-time reverse-transcription polymerase chain reaction (rRT-PCR) test is the only reliable option for the Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2). RT-PCR detects the genetic material of the virus but does not distinguish the infectious periods. Other diagnostic methods as serological tests and computed tomography (CT) are less accurate but can provide complementary information, especially in the face of new SARS-CoV-2 variants. Here, we report 2 cases of coronavirus-infected patients with recurrent RT-PCR positivity after recovery, which raised questions about possible reinfection. CASE REPORT A married couple, a 44-year-old woman and a 45-year-old man, after COVID-19 recovery, from April to August 2020 presented dynamic RT-PCR outcomes (oscillating from negative to positive). Anti-SARS-CoV-2 immunoglobulin G (IgG) levels for both patients were 1000 U/ml, indicating seroconversion. As a result of recurrent positivity, the patients were isolated and had limited access to healthcare. In the follow-up period, combining RT-PCR results with serology testing and CT allowed determination of the patients' infectiousness. CONCLUSIONS Due to emerging coronavirus variants, individuals with dynamic PCR results, especially with post-COVID-19 syndrome, are indistinguishable from those who are infectious. Misdiagnosis causes unnecessary quarantines and exacerbates the health care crisis. Patients who had dynamic RT-PCR for SARS-CoV-2 require different diagnostics methods from those used in patients with a first-time positive test result. Combining diagnostic methods and identification of new variants of SARS-CoV-2 allows better estimation of the risk of reinfection.
2019 年冠状病毒病（COVID-19）大流行给公共卫生危机管理带来挑战。实时逆转录聚合酶链反应（rRT-PCR）等有效检测方法是检测严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的唯一可靠方法。RT-PCR 检测病毒的遗传物质，但不能区分感染期。其他诊断方法，如血清学检测和计算机断层扫描（CT），准确性较低，但可以提供补充信息，尤其是在面对新的 SARS-CoV-2 变体时。在此，我们报告 2 例 COVID-19 康复后反复 RT-PCR 阳性的冠状病毒感染患者，这引起了对可能再次感染的质疑。
一对 44 岁的已婚夫妇，男性和女性，在 COVID-19 康复后，于 2020 年 4 月至 8 月期间出现动态 RT-PCR 结果（从阴性转为阳性）。两位患者的抗 SARS-CoV-2 免疫球蛋白 G（IgG）水平均为 1000 U/ml，表明发生了血清转换。由于反复出现阳性结果，患者被隔离，获得医疗服务的机会有限。在随访期间，将 RT-PCR 结果与血清学检测和 CT 相结合，可确定患者的传染性。
由于新兴的冠状病毒变体，动态 PCR 结果的个体，特别是患有 COVID-19 后综合征的个体，与具有传染性的个体无法区分。误诊会导致不必要的隔离，并加剧医疗保健危机。需要对具有动态 SARS-CoV-2 RT-PCR 的患者使用与首次阳性检测结果患者不同的诊断方法。结合诊断方法和鉴定 SARS-CoV-2 的新变体可以更好地估计再次感染的风险。
