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2020 ; 20
(1
): 500
Nephropedia Template TP
gab.com Text
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English Wikipedia
Recurrent pneumonia in a patient with new coronavirus infection after discharge
from hospital for insufficient antibody production: a case report
#MMPMID32652938
Zhou X
; Zhou J
; Zhao J
BMC Infect Dis
2020[Jul]; 20
(1
): 500
PMID32652938
show ga
BACKGROUND: The rapid spread of coronavirus disease 2019 (COVID-19) was declared
as an emerging public health threat by the World Health Organization. As various
measures have been taken successfully to combat the epidemic caused by
SARS-CoV-2, a growing number of fully recovered patients have been discharged
from hospitals. However, some of them have relapsed. Little is known about the
causes that triggered the relapse. CASE PRESENTATION: We report a case of a
40?years old man who suffered from recurrent pulmonary infection with progression
of lesions on chest computed tomography (CT), elevated levels of ferritin and
IL2R, reduced lymphocyte count and positive oropharyngeal swab test for
SARS-CoV-2 again after 5 days discharge from hospital. The anti-SARS-CoV-2
antibody level of this patient was very low at the time of relapse, suggesting a
weak humoral immune response to the virus. Total exon sequencing revealed
mutations in TRNT1 gene, which may be responsible for B cell immunodeficiency.
Therefore, uncleared SARS-CoV-2 at his first discharge was likely to lead to his
recurrence. However, viral superinfection and non-infectious organizing pneumonia
could not be completely excluded. CONCLUSION: COVID-19 relapse may occur in a
part of discharged patients with low titers of anti-SARS-CoV-2 antibodies. These
patients should be maintained in isolation for longer time even after discharge.
A more sensitive method to detect SARS-CoV-2 needs to be established and
serological testing for specific antibodies may be used as a reference to
determine the duration of isolation.