Recurrent Positivity of SARS-CoV-2 RNA in a Clinically Recovered COVID-19 Patient with End-stage Renal Disease: A Case Report

Nepal, Richa; Sapkota, Kalyan; Gurung, Santosh; Paudel, Pramod; Neupane, Prateek; Sah, Kamlesh Kumar

Recurrent or persistent positivity of severe acute respiratory syndrome coronavirus-2 RNA in clinically recovered coronavirus disease patients has been reported worldwide. However, replication-competent live viruses were not recovered beyond two to three weeks from the onset of symptoms in mild to severe cases of coronavirus disease. End-stage renal disease is characterized by uremia induced immune dysfunction that increases the risk of infectious diseases including coronavirus disease. The clinical implications of recurrent or persistently positive severe acute respiratory syndrome coronavirus-2 RNA in immunocompromised patients are difficult to be generalized to findings as in immunocompetent patients. We report a case of end-stage renal disease with a recent history of recovered coronavirus disease pneumonia, who again presented with positive reverse transcriptase-polymerase chain reaction test for severe acute respiratory syndrome coronavirus-2 RNA.