eight patients of COVID-19 with positive RT-PCR test after discharge

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ichs2020

The clinical characteristic of eight patients of COVID-19 with positive RT-PCR test after discharge.

  • Corona virus disease 2019 (COVID-19) was caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The phenomenon of positive real time reverse transcription polymerase chain reaction (RT-PCR) result of SARS-CoV-2 in recovered patients had occurred and the research about these patients was rare.
  • In our study, we did a retrospective review of medical records from COVID-19 patients admitted to one ward of Tongji Hospital of Hua Zhong University of Science and Technology from 10 February to 13 April 2020. From 10 February to 13 April 2020, there were 108 patients of COVID-19 admitted in the one ward of Tongji Hospital. Among them, eight cases were readmission patients because the RT-PCR result of SARS-CoV-2 was positive again after discharge. On the second admission, they had no symptoms and their chest CT was almost normal.
  • Data from laboratory tests of the re-admission patients showed that all eight patients had normal white blood cell count, lymphocyte count. The inflammatory factors like procalcitonin and interleukin 6 were normal. After treatment, two patients met the standard and were discharged. The other six patients were still in the hospital because their RT-PCR of SARS-CoV-2 did not get three consecutive negative results and the course of two patients had persisted more than 90 days.
  • We still needed to be alert that these patients could infect other people as a source of infection, and we also needed to be alert that these patients become chronic virus carriers. It also aroused our concern about the discharge standard of COVID-19. This article is protected by copyright. All rights reserved.
ichs2020

ichs2020

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COVID-19-assoziierte Pneumonie trotz persistierend negativen PCR–Tests aus oropharyngealen Abstrichen.

  • A 46-year old construction worker presented at the emergency department with two orthostatic syncopes. The patient complained of prolonged fever and coughs for 7 days which had not improved after oral treatment with sultamicillin for 5 days, prescribed by the patient’s general practitioner. Physical examination showed high blood pressure due to previously known hypertension.
  • Other vital signs without pathological findings. Pulmonary auscultation showed basal soft crackling noises of the left lung FINDINGS AND DIAGNOSIS: Laboratory examination showed increased values for LDH, pro-BNP and CRP and normal values for leucocytes and procalcitonin.
  • Conventional X-Ray of the chest showed bipulmonal lateral atypical infiltrates. After the first PCR turned in negative another PCR-analysis for SARS-CoV-2 of a deep oral swab-sample was performed since the clinical, laboratory and radiological findings were typical for COVID-19. Again, SARS-CoV-2-RNA was not detected.
  • A CT-scan of the chest showed bipulmonal lateral ground-glass attenuation, again typical for COVID-19 associated pneumonia. After a third attempt for a PCR-analysis of a deep oral swab-sample was negative, analysis of a sputum was performed which finally confirmed the diagnosis of COVID-19 associated pneumonia. The patient was admitted for evaluation of syncopes and suspect of COVID-19 associated pneumonia. The patient was prophylactically isolated while the result of SARS-CoV-2-PCR from a deep oral swab was pending.
  • Suspecting a possible secondary bacterial infection at the beginning, intravenous antibiotic treatment with ampicillin/sulbactam was initiated. While further examinations showed no indication for bacterial infection, antibiotics were discontinued after 3 days. Due to clinical recovery antiviral therapy was not performed after confirming the diagnosis.
  • The patient was discharged 17 days after onset of first symptoms without any requirements for further isolation. This casuistic describes a case of COVID-19 associated pneumonia presenting with typical clinical features, laboratory and radiological findings.
  • Detection of viral RNA was not successful from deep oral swab-samples despite repeated attempts. Finally, PCR-analysis of sputum confirmed the diagnosis. Analysis of deeper airway samples (sputum, bronchoalveolar lavage, tracheal secretions) or stool for SARS-CoV-2 should be performed in cases of evident clinical suspicion of COVID-19 and negative PCR results from deep oral swabs

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Monkeypox Virus Real Time PCR Kit
ZD-0076-01 25 tests/kit Ask for price
Description: Monkeypox virus is the virus that causes the disease monkeypox in both humans and animals. Monkeypox virus is an Orthopoxvirus, a genus of the family Poxviridae that contains other viral species that target mammals. The virus is mainly found in tropical rainforest regions of central and West Africa. The primary route of infection is thought to be contact with the infected animals or their bodily fluids. The genome is not segmented and contains a single molecule of linear double-stranded DNA, 185000 nucleotides long. The Monkeypox Virus real time PCR Kit contains a specific ready-to-use system for the detection of the Monkeypox Virusthrough polymerase chain reaction (PCR) in the real-time PCR system. The master contains reagents and enzymes for the specific amplification of the Monkeypox Virus DNA. Fluorescence is emitted and measured by the real time systems ́ optical unit during the PCR. The detection of amplified Monkeypox Virus DNA fragment is performed in fluorimeter channel 530nm with the fluorescent quencher BHQ1. DNA extraction buffer is available in the kit and serum or lesion exudate samples are used for the extraction of the DNA. In addition, the kit contains a system to identify possible PCR inhibition by measuring the 560nm fluorescence of the internal control (IC). An external positive control defined as 1×10^7 copies/ml is supplied which allow the determination of the gene load.

Monkeypox Virus Real Time PCR Kit
ZD-0076-02 25 tests/kit Ask for price
Description: Monkeypox virus is the virus that causes the disease monkeypox in both humans and animals. Monkeypox virus is an Orthopoxvirus, a genus of the family Poxviridae that contains other viral species that target mammals. The virus is mainly found in tropical rainforest regions of central and West Africa. The primary route of infection is thought to be contact with the infected animals or their bodily fluids.The genome is not segmented and contains a single molecule of linear double-stranded DNA, 185000 nucleotides long.The Monkeypox Virus real time PCR Kit contains a specific ready-to-use system for the detection of the Monkeypox Virusthrough polymerase chain reaction (PCR) in the real-time PCR system. The master contains reagents and enzymes for the specific amplification of theMonkeypox VirusDNA. Fluorescence is emitted and measured by the real time systems ́ optical unit during the PCR. The detection of amplified Monkeypox Virus DNA fragment is performed in fluorimeter channelFAM with the fluorescent quencher BHQ1. DNA extraction buffer is available in the kit and serum or lesion exudate samples are used for the extraction of the DNA. In addition, the kit contains a system to identify possible PCR inhibition by measuring the HEX/VIC/JOE fluorescence of the internal control (IC). An external positive control defined as 1×107copies/ml is supplied which allow the determination of the gene load.

Monkeypox Virus Real Time PCR Kit
YJC70115NW-25T 25 tests/kit Ask for price
Description: The Bioperfectus Monkeypox Virus Real Time PCR Kit is an in vitro diagnostic test, based on real-time PCR technology, for the detection of DNA from the Monkeypox virus. Specimens can be obtained from human serum, lesion exudate samples and scab. BSL-2 facilities with standard BSL-2 work practices may be used for the test of t he Monkeypox virus.

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