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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Case report
Prolonged RNA shedding of the 2019 novel coronavirus in an asymptomatic patient with a VP shunt
  1. Firas El-Baba1,2,
  2. Danielle Gabe3 and
  3. Allan Frank2,3
  1. 1Internal Medicine and Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA
  2. 2Internal Medicine, Detroit Medical Center, Detroit, Michigan, USA
  3. 3Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
  1. Correspondence to Dr Firas El-Baba; felbaba{at}med.wayne.edu

Abstract

A 33-year-old man with paranoid schizophrenia and a ventriculoperitoneal (VP) shunt was sent to our institution from an inpatient psychiatric facility due to concerns for the 2019 novel coronavirus (COVID-19). Per the facility, the patient had a fever and non-productive cough. On admission, the patient was afebrile and lacked subjective symptoms. A RNA reverse transcriptase PCR (RNA RT-PCR) test for COVID-19 was positive. A chest X-ray contained a small patchy opacity in the right middle lobe and another in the retrocardiac region concerning for pneumonia. Inflammatory markers were mildly elevated. He remained COVID-19 positive and asymptomatic for 36 days. This case details one asymptomatic carrier’s course with persistently positive COVID-19 nasopharyngeal swabs. It demonstrates that a VP shunt could be a possible predisposition for prolonged viral shedding.

  • infectious diseases
  • respiratory medicine

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-2020-237720

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    Footnotes

    • Contributors FE-B, DG and AF were all involved in this project. All provided substantial contributions to the conception of case report, drafted the original work and revised the copy, all approved the final project and agreed to be accountable for all aspects of the work ensuring that questions related to the accuracy or integrity of any part of the work.

    • 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.