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Recurrent and More Severe COVID-19 Infection: Two Elderly Case Reports
Erhan Uğurlu1, Nilüfer Yiğit1, Nazlı Çetin1
1Department of Chest Diseases, Pamukkale University School of Medicine, Denizli, Turkey.
Insights
Two patients discharged with negative RT-PCR tests for coronavirus disease 2019 (COVID-19) later experienced symptom recurrence and tested positive. This case study explores recurrent COVID-19 infection and treatment strategies.
Area of Science:
- Medicine
- Infectious Diseases
- Pulmonology
Background:
- Reverse transcriptase-polymerase chain reaction (RT-PCR) is the gold standard for COVID-19 diagnosis, despite limitations in sensitivity.
- Clinical improvement, radiological resolution, and negative RT-PCR results guide patient discharge decisions.
- Recurrent infections pose challenges in managing coronavirus disease 2019.
Purpose of the Study:
- To present two cases of recurrent coronavirus disease 2019 (COVID-19) after initial recovery and discharge.
- To discuss the management and treatment of these recurrent COVID-19 cases.
Main Methods:
- Retrospective review of two hospitalized COVID-19 patients.
- Analysis of clinical presentation, treatment course, and RT-PCR results before and after discharge.
Main Results:
- Two patients initially discharged with resolved symptoms and negative RT-PCR results presented with recurrent COVID-19 symptoms.
- Both patients tested positive for COVID-19 upon readmission, indicating potential reinfection or prolonged viral shedding.
Conclusions:
- Negative RT-PCR results at discharge do not always preclude recurrent coronavirus disease 2019.
- Further investigation into recurrent COVID-19 and optimized discharge criteria is warranted.
Abstract:
Although the sensitivity of reverse transcriptase-polymerase chain reaction (RT-PCR) is low in the diagnosis of coronavirus disease 2019 (COVID-19), it is the gold standard. Clinical improvement is prioritized in the follow-up of patients with COVID-19 who are followed as possible or definitive cases. Although the priority in the discharge decision is the resolution of complaints, it is also important to see radiological improvement and RT-PCR negativity. A total of 2 of our patients who were hospitalized and treated in our clinic with a diagnosis of COVID-19 were discharged after their complaints were resolved and their treatment was completed. The patients had 2 negative RT-PCR results at discharge. Both of them presented to the hospital with symptoms such as fever, cough, and shortness of breath after the discharge, and both showed positive RT-PCR results. Considering recurrent COVID-19 infection, we aimed to present treatment and the 2 cases we followed.
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