Prolonged SARS-CoV-2 RNA shedding in a young man recovering from traumatic pneumothorax
Umunnakwe, C. N.; Makatini, Z. N.; Mdunyelwa, A.; Maphanga, M.; Nijhuis, M.; Wensing, A.; Tempelman, H. A.
(2022) South African Medical Journal, volume 112, issue 2
(Article)
Abstract
We describe a case of prolonged SARS-CoV-2 RNA shedding in an HIV-negative 21-year-old man recovering from abdominal and thoracic trauma. Nasopharyngeal (NP) swabs collected at 12 time points over a 95-day span all tested positive for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR). Genotyping revealed canonical beta-variant E484K and
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N501Y mutations at earlier time points. Human rhinovirus, coronavirus NL63 and respiratory syncytial virus B were detected at different time points by RT-PCR. Full blood analysis at time point 9 (day 82) showed leukopenia with lymphocytosis. The patient's NP swab tested negative for SARS-CoV-2 by RT-PCR 101 days after the first positive test. The prolonged duration of SARS-CoV-2 RNA shedding in the context of trauma presented here is unique and has important implications for COVID-19 diagnosis, management and policy guidelines.
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Keywords: COVID-19/diagnosis, COVID-19 Nucleic Acid Testing, Genotype, Humans, Male, Pneumothorax/physiopathology, RNA, Viral/isolation & purification, SARS-CoV-2/genetics, Time Factors, Virus Shedding, Young Adult, General Medicine, Case Reports, Journal Article
ISSN: 0256-9574
Publisher: South African Medical Association
Note: Funding Information: Declaration. None. Acknowledgements. We thank the staff of Ndlovu Medical Centre and Ndlovu Research Centre for assisting in acquiring follow-up clinical and molecular diagnostic data for the patient. We would also like to thank the patient for his participation. Author contributions. CNU and HAT conceived of and designed the study. CNU, AM and MM performed SARS-CoV-2 and respiratory panel RT-PCR, rapid antigen testing, FBC analysis, SARS-CoV-2 genotyping and SARS-CoV-2 cDNA synthesis, primer pool preparation and PCR multiplexing for SARS-CoV-2 Artic sequencing, and CNU performed data analysis. All authors contributed towards the writing of the manuscript, initially drafted by CNU, ZNM and HAT. All authors contributed towards editing and proofreading and approved the final submitted version. Funding. This work was funded by Ndlovu Research Consortium. Conflicts of interest. None. Publisher Copyright: © 2022 South African Medical Association. All rights reserved.
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