Case series: significance of positive sars-cov-2 rt-pcr in a cured patient: persistent non-viable viral shedding versus true infection

With the emergence of SARS-COV-2 as a cause of COVID 19 disease in December 2019 in Wuhan, China, and the spread of the infection later, down to its declaration a pandemic by the World Health Organization (WHO) in March 2020, there are still many questions that must be answered, among which the significance of an RT-PCR test turning positive after announcing a patient’s recovery, and how should physicians act in the face of such a situation. In our case series, we describe the clinical characteristics of fourteen patients who had recovered from COVID-19 infection between March and May 2020, and who had retested positive after at least one week. Thirteen out of fourteen patients were asymptomatic upon retesting. Only one patient developed symptoms after being declared cured with positive RT-PCR. Upon reassessment, the patient had mild disease with no lower respiratory tract involvement. During the period between recovery and re-admission, the patient was self-isolating at home, so there was no contact tracing to see how contagious the disease was in this episode. We concluded that most of the available data on retesting positive after recovery suggest the presence of a non-viable viral genome segment, since the PCR only detects the genome and not the viable virus. However, in the presence of symptoms, the patient should be considered contagious until more solid scientific data come out.