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  • Persistent positivity of SARS-CoV-2 nucleic acid in asymptomatic healthcare worker: infective virion or inactive nucleic acid?

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Global health
Persistent positivity of SARS-CoV-2 nucleic acid in asymptomatic healthcare worker: infective virion or inactive nucleic acid?
  1. Lokesh Tiwari1,
  2. Prakriti Gupta1,
  3. Chandra Mani Singh2 and
  4. Prabhat Kumar Singh3
  1. 1Pediatrics, All India Institute of Medical Sciences, Patna, India
  2. 2Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
  3. 3Director, All India Institute of Medical Sciences, Patna, India
  1. Correspondence to Dr Lokesh Tiwari; lokeshdoc{at}yahoo.com

Abstract

Asymptomatic individuals positive for SARS-CoV-2 RNA constitute a significant proportion of the infected population and play a role in the transmission of the virus. We describe a healthcare worker who presented with fever and malaise and was diagnosed with mild COVID-19. The symptoms resolved within 4 days but there was persistent positivity of viral RNA in the upper respiratory tract for more than 58 days, which is the longest reported duration of persistence of SARS-CoV-2 in a healthcare worker. In this case report, we discuss clinical and administrative issues such as the role of asymptomatic cases in the transmission of the virus to patients and coworkers as an occupational hazard, interpretation of persistent positivity of nucleic acid test, duration of isolation and return-to-work guidelines pertinent to researchers and global health policymakers.

  • COVID-19
  • global health
  • healthcare improvement and patient safety
  • infectious diseases

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2020-241087

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    Footnotes

    • Contributors LT: concept and planning, case management decisions, forming administrative plan, supervised initial draft, review of literature, analysis and final drafting of the manuscript. PG: involved in patient management, literature search and initial drafting of the manuscript. CMS: administrative decisions, review of literature and final drafting of the manuscript. PKS: administrative and policy decisions and final drafting of the manuscript. All authors contributed to the final manuscript. LT and CMS had full access to all of the data and verified the data. LT was responsible for manuscript submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.