Kyungpook National University Hospital [Neurosurgery Wiki]

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====== Kyungpook National University Hospital ======

Department of Neurosurgery, [[Kyungpook National University Hospital]], [[Daegu]], [[Korea]].

The clinical course and viral detection period in mild or asymptomatic [[coronavirus disease]] 2019 (COVID-19) patients are not yet known. The presumed low diagnostic sensitivity of upper respiratory specimens for Severe Acute Respiratory Syndrome Coronavirus-2 ([[SARS-CoV-2]]) makes it difficult to confirm infection and recommend de-isolation.

Kim et al. retrospectively reviewed real-time reverse transcriptase-polymerase chain reaction ([[RT-PCR]]) test results of mild or asymptomatic COVID-19 patients who were admitted at the Daegu-Gyeongbuk 7th community treatment center in Korea between 9 March 2020 and 10 April 2020. Patients underwent an upper respiratory RT-PCR test every week until discharge. From the RT-PCR results, we evaluated the rate of prolonged (>3 weeks) SARS-CoV-2 RNA positivity. They analyzed the proportion of reversed results, defined as a positive or indeterminate result one day after a negative RT-PCR result, according to time (<14, 15-21, 22-28, >28 days) from the initial positive RT-PCR result.

In 23% (69/300) of patients, SARS-CoV-2 was detected more than 3 weeks after the initial positive RT-PCR. In 14% (42/300) of patients, the RT-PCR results were positive for more than 4 weeks. For 37.5% (152/405) of negative RT-PCR results, the results were reversed in the next day's test. And 43.5% (123/283) of negative RT-PCR results were reversed within 3 weeks of diagnosis.

The detection of SARS-CoV-2 lasting more than 3 weeks was common in mild or asymptomatic patients. Upper respiratory RT-PCR results were frequently reversed from negative to positive
((Kim SM, Hwang YJ, Kwak Y. Prolonged SARS-CoV-2 detection and reversed RT-PCR results in mild or asymptomatic patients [published online ahead of print, 2020 Sep 16]. Infect Dis (Lond). 2020;1-7. doi:10.1080/23744235.2020.1820076))