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Symptomatic relapse and long-term sequelae of COVID-19 in a previously healthy 30-year-old man
  1. Hatem Abdallah,
  2. Florence Porterfield and
  3. David Fajgenbaum
  1. Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to Hatem Abdallah; Hatem.Abdallah{at}pennmedicine.upenn.edu

Abstract

Much has been reported on the clinical course of severe COVID-19, but less is known about the natural history and sequalae of mildly symptomatic cases and the prospects of reinfection or recurrence of symptoms. We report a case of a patient with mildly symptomatic PCR-confirmed COVID-19 who, after being symptom-free for 2 weeks, redeveloped symptoms and was found to be PCR-positive again >4 weeks from original testing. Surprisingly, IgG and IgM antibody testing was negative 2 months after reinfection. Although no negative testing was performed between the two symptomatic bouts, this case raises the possibility of reinfection after controlling the virus and highlights the long period with which a patient can shed virus and experience symptoms after initial infection. Characterising variations in clinical symptoms and length of viral shedding after improvement is essential for informing recommendations on patients safely resuming contact with others.

  • infectious diseases
  • public health
  • migration and health
  • TB and other respiratory infections

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Footnotes

  • HA and FP contributed equally.

  • Contributors HA: data collection, manuscript writing. FP: data collection, manuscript writing. DF: manuscript writing.

  • 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.