Persistent viral shedding lasting over 60 days in a mild COVID-19 patient with ongoing positive SARS-CoV-2

A novel coronavirus named a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is sweeping across the entire world rapidly, infecting enormous number of people. Positive real-time reverse transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 nucleic acid is regarded as the main diagnostic modality for coronavirus disease 2019 (COVID-19) (1). According to the latest Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19), the median time from onset to clinical recovery for mild cases is approximately 2 weeks (2). Currently, there is no available data to predict how long positive SARS-CoV-2 detectability can last in the COVID-19 patients following recovery of clinical symptoms. Hereby we report a confirmed COVID-19 patient with only mild clinical symptoms, who has been admitted from January 26 to present (March 27), 2020, at the central hospital of Lankao county, Henan province, China. The patient has been hospitalized for over 60 days due to her ongoing positive SARS-CoV-2 status. Currently she becomes an asymptomatic coronavirus carrier. To our knowledge, this COVID-19 patient has the longest reported positive SARS-CoV-2 status post-treatment, indicating persistent viral shedding. With the ongoing global pandemics, this case highlights the urgency for more epidemiology and virology work to be done to better understand SARS-CoV-2, also the need of being aware of encountering and treating SARS-CoV-2 carrier transformed from COVID-19 patient after treatment. The possibility of chronic SARS-CoV-2 carrier status also puts on a new challenge for current clinical treatment. A 47-year-old female lives in Wuhan, Hubei Province of China, went back to her hometown (Lankao county, Henan Province) on January 14 for Chinese New Year’s family reunion. She began to cough with expectoration, followed by dizziness, headache, nausea and vomiting on January 22. On January 26, she was admitted to the local hospital with low fever [37.5°C (99.5 °F)], oppressive chest pain and aggravated cough. Her initial laboratory results showed 9.26 mg/L of C-reactive protein (normal range: 0–5 mg/L), 0.1% of eosinophil ratios (normal range: 0.4–8%), 72.5% of neutrophil ratios (normal range: 40.0–75.0%), 21.5% of lymphocyte ratios (normal range: 20.0–50.0%), and throat swab RTPCR test confirmed COVID-19 infection. Her initial chest CT showed bilateral mixed subpleural ground glass opacities (GGO) and consolidation (Figure 1). After 7 days of antiviral treatment and supportive therapy, the patient’s temperature returned to normal, and repeated CT on February 3 showed interval improvement of the lung changes (Figure 2). With ongoing treatment, on February 12 (3 weeks after initial onset of symptoms), the patient’s respiratory symptoms, including cough, expectoration and chest tightness, had significantly relieved. On corresponding chest CT, the previous bilateral air space changes had also markedly absorbed (Figure 3). The Letter to the Editor