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Absent immune response to SARS-CoV-2 in a 3-month recurrence of coronavirus disease 2019 (COVID-19) case
- Source :
- Infection
- Publication Year :
- 2020
- Publisher :
- Springer Berlin Heidelberg, 2020.
-
Abstract
- Background The viral persistence in patients with Coronavirus Disease 2019 (COVID-19) remains to be investigated. Methods We investigated the viral loads, therapies, clinical features, and immune responses in a 70-year patient tested positive for SARS-CoV-2 for 3 months. Findings The patient exhibited the highest prevalence of abnormal indices of clinical features and immune responses at the first admission, including fever (38.3 ℃), decreased lymphocytes (0.83 × 109/L) and serum potassium (3.1 mmol/L), as well as elevated serum creatinine (115 µmol/L), urea (8.6 mmol/L), and C-reactive protein (80 mg/L). By contrast, at the second and the third admission, these indices were all normal. Through three admissions, IL-2 increased from 0.14 pg/mL, 0.69 pg/mL, to 0.91 pg/mL, while IL-6 decreased from 11.78 pg/mL, 1.52 pg/mL, to 0.69 pg/mL, so did IL-10 from 5.13 pg/mL, 1.85 pg/mL, to 1.75 pg/mL. The steady declining trend was also found in TNF-α (1.49, 1.15, and 0.85 pg/mL) and IFN-γ (0.64, 0.42, and 0.27 pg/mL). The threshold cycle values of RT-PCR were 26.1, 30.5, and 23.5 for ORFlab gene, and 26.2, 30.6, and 22.7 for N gene, showing the patient had higher viral loads at the first and the third admission than during the middle term of the disease. The patient also showed substantially improved acute exudative lesions on the chest CT scanning images. Conclusions The patient displayed declining immune responses in spite of the viral shedding for 3 months. We inferred the declining immune responses might result from the segregation of the virus from the immune system.
- Subjects :
- 0301 basic medicine
Male
Disease
Long-term viral shedding
Gastroenterology
0302 clinical medicine
COVID-19 Testing
Recurrence
Medicine
030212 general & internal medicine
Reverse Transcriptase Polymerase Chain Reaction
Novel coronavirus (SARS-CoV-2)
General Medicine
Viral Load
Interleukin-10
Virus Shedding
Hospitalization
Elevated serum creatinine
Infectious Diseases
C-Reactive Protein
Creatinine
Tumor necrosis factor alpha
Viral load
Microbiology (medical)
medicine.medical_specialty
Fever
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
030106 microbiology
Antiviral Agents
Virus
03 medical and health sciences
Interferon-gamma
Immune system
Internal medicine
Lymphopenia
Humans
Viral shedding
Immune response
Aged
Original Paper
business.industry
Interleukin-6
SARS-CoV-2
Tumor Necrosis Factor-alpha
Immunity
COVID-19
Coronavirus disease 2019 (COVID-19)
Interleukin-2
business
Tomography, X-Ray Computed
Biomarkers
Subjects
Details
- Language :
- English
- ISSN :
- 14390973 and 03008126
- Database :
- OpenAIRE
- Journal :
- Infection
- Accession number :
- edsair.doi.dedup.....43d8a1b1c63fd65cc4481600d86c1072