Côté Florence, Bestman-Smith Julie, Gourdeau Marie, Simpson Shawn M, Hamelin Marie-Ève, Carbonneau Julie, Chiasson Antoine, Rozendaal Marieke, Smith Martin A, Boivin Guy
Département de microbiologie et infectiologie, Hôpital de l'Enfant-Jésus, CHU de Québec - Université Laval, Quebec, Quebec, Canada.
CHU Sainte-Justine Research Centre, Montreal, Quebec, Canada.
J Assoc Med Microbiol Infect Dis Can. 2022 Sep 27;7(3):283-291. doi: 10.3138/jammi-2021-0036. eCollection 2022 Sep.
COVID-19 is usually a time-limited disease. However, prolonged infections and reinfections can occur among immunocompromised patients. It can be difficult to distinguish a prolonged infection from a new one, especially when reinfection occurs early.
We report the case of a 57-year-old man infected with SARS-CoV-2 while undergoing chemotherapy for follicular lymphoma. He experienced prolonged symptomatic infection for 3 months despite a 5-day course of remdesivir and eventually deteriorated and died.
Viral genome sequencing showed that his final deterioration was most likely due to reinfection. Serologic studies confirmed that the patient did not seroconvert.
This case report highlights that reinfection can occur rapidly (62-67 d) among immunocompromised patients after a prolonged disease. We provide substantial proof of prolonged infection through repeated nucleic acid amplification tests and positive viral culture at day 56 of the disease course, and we put forward evidence of reinfection with viral genome sequencing.
新型冠状病毒肺炎（COVID-19）通常是一种自限性疾病。然而，免疫功能低下的患者可能会出现长时间感染和再次感染。区分长时间感染和新感染可能很困难，尤其是在早期发生再次感染时。
我们报告了一名57岁男性的病例，该患者在接受滤泡性淋巴瘤化疗时感染了严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。尽管接受了为期5天的瑞德西韦治疗，但他仍经历了长达3个月的有症状感染，最终病情恶化并死亡。
病毒基因组测序显示，他的最终病情恶化很可能是由于再次感染。血清学研究证实该患者未发生血清转化。
本病例报告强调，免疫功能低下的患者在长时间患病后可能会迅速（62 - 67天）发生再次感染。我们通过重复核酸扩增试验以及病程第56天病毒培养阳性提供了长时间感染的充分证据，并通过病毒基因组测序提出了再次感染的证据。
