In Practice

Prolonged SARS-CoV-2 RNA shedding in a young man recovering from traumatic pneumothorax

C N Umunnakwe, Z N Makatini, A Mdunyelwa, M Maphanga, M Nijhuis, A Wensing, H A Tempelman

Abstract


We describe a case of prolonged SARS-CoV-2 RNA shedding in an HIV-negative 21-year-old man recovering from abdominal and thoracic trauma. Nasopharyngeal (NP) swabs collected at 12 time points over a 95-day span all tested positive for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR). Genotyping revealed canonical beta-variant E484K and N501Y mutations at earlier time points. Human rhinovirus, coronavirus NL63 and respiratory syncytial virus B were detected at different time points by RT-PCR. Full blood analysis at time point 9 (day 82) showed leukopenia with lymphocytosis. The patient’s NP swab tested negative for SARS-CoV-2 by RT-PCR 101 days after the first positive test. The prolonged duration of SARS-CoV-2 RNA shedding in the context of trauma presented here is unique and has important implications for COVID-19 diagnosis, management and policy guidelines

Authors' affiliations

C N Umunnakwe, Ndlovu Laboratories, Elandsdoorn, Limpopo Province, South Africa; Ndlovu Research Consortium, Elandsdoorn, Limpopo Province, South Africa

Z N Makatini, Ndlovu Research Consortium, Elandsdoorn, Limpopo Province, South Africa; Department of Virology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

A Mdunyelwa, Ndlovu Laboratories, Elandsdoorn, Limpopo Province, South Africa

M Maphanga, Ndlovu Laboratories, Elandsdoorn, Limpopo Province, South Africa

M Nijhuis, Ndlovu Research Consortium, Elandsdoorn, Limpopo Province, South Africa; Department of Medical Microbiology, Virology, University Medical Center Utrecht, Netherlands; HIV Pathogenesis Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

A Wensing, Ndlovu Research Consortium, Elandsdoorn, Limpopo Province, South Africa; Department of Medical Microbiology, Virology, University Medical Center Utrecht, Netherlands; Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa

H A Tempelman, Ndlovu Laboratories, Elandsdoorn, Limpopo Province, South Africa; Ndlovu Research Consortium, Elandsdoorn, Limpopo Province, South Africa; Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa

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Keywords

SARS-CoV-2 RNA; Prolonged shedding; COVID-19; Long-term shedding; Viral persistence; COVID PCR cycle threshold; COVID genotyping; Pneumothorax

Cite this article

South African Medical Journal 2022;112(2):81-85.

Article History

Date submitted: 2022-02-01
Date published: 2022-02-01

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