Long-term Positivity to SARS-CoV-2: A Clinical Case of COVID
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A 65-year-old woman was admitted to the Internal Medicine Department of Chieti Hospital on with a 7-day history of both fever and cough. The patient’s medical history included arterial hypertension and hypothyroidism. She underwent a chest x-ray, ultrasound of the thorax according to indications in the literature, and a CT scan of the thorax with evidence of interstitial pneumonia and respiratory failure. Arterial blood gas (ABG) analysis showed mild hypoxemic hypocapnic respiratory failure, which was treated with 1 l/min of oxygen via a nasal cannula.

The laboratory investigations demonstrated lymphocytopenia, and elevated C-reactive protein and lactate dehydrogenase. These findings suggested COVID-19. A nasopharyngeal swab for SARS-CoV-2 taken at admission was positive, so darunavir/cobicistat 800/150 mg once a day plus hydroxychloroquine 200 mg twice a day were initiated. The patient rapidly improved and after 5 days was afebrile. At the 2 weeks after admission, she was completely asymptomatic, and laboratory tests showed no lymphocytopenia and a large reduction in C-reactive protein from 245 to 7.6 mg/l. The respiratory failure had also resolved and radiology showed improvement with a reduction in signs of bilateral pneumonia. However, a nasopharyngeal swab was still positive for SARS-CoV-2 on 31 March.

This case may help us to better understand COVID-19 and the time required between clinical and microbiological healing, especially from an epidemiological perspective, and the necessity of quarantine to limit possible SARS-CoV-2 spread, particularly in the case of long-term positivity.

Source: https://www.ejcrim.com/index.php/EJCRIM/article/view/1707/2109
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