A special case of COVID-19 with long duration of viral shedding for 49 days

Li Tan; Xia Kang; Bo Zhang; Shangen Zheng; Bo Liu; Tiantian Yu; Fan Yang; Qiongshu Wang; Hongming Miao

The copyright holder for this preprint . https://doi.org/10.1101/2020.03.22.20040071 doi: medRxiv preprint quickly screen out the patients who needed to be hospitalized or to stay at home. The status of lymphocytes and duration of viral shedding are two most common indicators in predicting prognosis of COVID-19 patients. However, it is still unclear which one of them is more reliable and more efficient. In the present study, IgG antibody can be detected in Case 1 from Feb. 20, indicating Case 1 can initiate immune responses to viral infection. However, the mRNA level of virus in Case 1 showed a similar trend to that of death cases. Taken together, these findings indicated that immune indicators could be more sensitive and reliable than viral shedding in reflecting the overall status of patients and predicting the prognosis. Actually, a recent study found that recruitment of T cells and the presence of IgG and IgM antibodies can be found before the resolution of symptoms in COVID-19 patients 13 . Therefore, we strongly suggest that immune indicators, especially the level of lymphocytes, could be a better prognostic indicator than duration of viral shedding, especially for patients in early stage.