A middle-aged man under observation for COVID-19 proved active for 49 days in an early (preprint) report from China. The signs were not severe – his immune cell indicators remained stable. It was his COVID-19 viral load that remained high for a previously unseen amount of time. NOTE: At the point at which this article was published, the original data had not been peer-reviewed – we will be keeping an eye on the original report and will update as necessary.
A special note: – While the authors of this report have published reports in the past, this particular research had not been peer reviewed at the point at which it was first widely reported by media sources like South China Morning Post and BGR and the New York Post. It is vital that all parties keep the preprint, not-yet-peer-reviewed nature of this information in mind while reading and/or sharing.
The cases described in the report from China included one 40-50 year old male and one 70-80 year old female. The female was admitted to the hospital approximately 11 days after symptom onset. She had a sustained cough throughout the observation period, but no fever after admission.
The female patient had a positive virus RNA test 8 days after showing signs of illness, then a virus RNA test 12 days after signs showed negative, then positive 2 days later, then negative for the next two tests on the 24th and 26th days.
The male was admitted to the hospital 15 days after showing signs of illness. He had a fever for the first 19 days, but no cough. The male patient showed negative for a virus RNA test at admission on day 15, then positive on days 17, 22, 26, 30, 34, 39, and 43. On day 47, he had a negative virus RNA test result.
Then on day 49, the patient showed positive virus RNA test results again. On day 51 he had a plasma infusion, then he showed negative virus RNA test results for the 52nd and 53rd day.
The authors of this report wrote that the switch in RNA test results from positive to negative to positive suggest the potential for “dynamic balance.” The viral duplication was suppressed, they said, but “immune cells cannot clear out the virus.” Patients with mild symptoms, like the male in this study, are “likely to be neglected” and could “persist infecting surroundings and cause a new outbreak” according to the authors of the research.
Their conclusion and note for expansion
The authors of the report wrote that they observed a “special family cluster case [for COVID-19], of which one member has the longest duration of viral shedding in current reports.” They went on to note that “the virus infecting this family cluster case appeared low toxicity and low transmissibility. However, it also showed a prolonged infective ability and was hardly to be eliminated in body.”
The doctors made note that “This virus type may exist in human bodies for a long time and may be a risk to contribute to periodic outbreak in future considering the high mutation in COVID-19.”
More information in original study
The research paper mentioned in the article above goes by the name A special case of COVID-19 with long duration of viral shedding for 49 days, as published (preprint) by medRXiv on March 27, 2020. This paper was authored by Li Tan, M.D., Ph.D., Xia Kang, M.D., Ph.D., Bo Zhang, M.D., Shangen Zheng, M.D., Ph.D., Bo Liu, M.D., Tiantian Yu, M.S., Fan Yang, Ph.D., Qiongshu Wang, M.D., Ph.D., Hongming Miao, M.D., Ph.D. and was published (preprint) with DOI:10.1101/2020.03.22.20040071 on the 22nd of March, 2020.
Author affiliations for the report include: Department of Disease Control and Prevention (L.T., T.Y., Q.W.), Department of Infectious Disease (B.Z.) and Department of Transfusion (S.Z.) in General Hospital of Central Theater Command, Department of Biochemistry and Molecular Biology in Third Military Medical University (Army Medical University) (X.K., F.Y., H.M.) and Department of Laboratory in No. 967 Hospital of PLA (B.L.).