A case report of moderate COVID-19 with an extremely long-term viral shedding period in China

Abstract

Background: An ongoing outbreak of novel coronavirus disease 2019 (COVID-19) from Wuhan, China, is currently recognized as a global public health emergency, which has subsequently spread to the rest of China and other countries. The WHO raised the COVID-19 alert to the highest level. The virus is a new highly contagious via human-to-human transmission. The median duration of viral shedding is 20.0 days. We report that the longest duration of viral shedding was 32.0 days from illness onset in a patient with moderate COVID-19 admitted to QianJiang Central Hospital.Case presentation: A 37-year-old male sought medical advice while suffering from fever, dry cough, fatigue, dizziness, runny nose and diarrhoea. Five days before the visit, he had a history of travel from affected geographic areas. The patient had a positive RT-PCR test, and chest CT images showed multiple nodules and mixed ground-glass opacification with consolidation in both lungs. Laboratory findings showed that his lymphocyte and CD4+ counts were below the normal range. The patient was given antiviral treatment, including arbidol, lopinavir, IFN-α, and traditional Chinese medicine, and other necessary support care. All clinical symptoms and CT imaging manifestation abnormalities resolved during the course of therapy.Conclusion: Although the positive RT-PCR tests were verified in consecutive upper respiratory specimens, the clinical symptoms, CT imaging findings, CD4+ lymphocyte counts, and IgG antibody levels had obviously improved. Positive tests may be detecting pieces of inactive viruses, which would not be transmissible in individual cases.