An Immunocompetent Patient with High Neutralizing Antibody Titers Who Shed COVID-19 Virus for 169 days — China, 2020

Li, Li; Li, Siqi; Pan, Yang; Qin, Ling; Yang, Siyuan; Tan, Dawei; Hu, Yaling; Knoll, Maria Deloria; Wang, Xiaoli; Wang, Linghang; Wang, Quanyi

Few reports are available about prolonged shedding of coronavirus disease (COVID-19) virus, also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), by immunocompetent patients. We report a case of an infected, immunocompetent person with 169 days of COVID-19 virus shedding during which time he had two brief periods when he tested negative for COVID-19 followed by again testing positive. We describe relevant clinical, immunological, and genomic features. We found that continuous and prolonged viral replication and infectivity existed in an immunocompetent COVID-19 patient, despite having high neutralizing antibody titers. INTRODUCTION Previous case reports have described immunocompromised patients shedding COVID-19 virus RNA for 105 days and 153 days, and to our knowledge, the longest reported duration of COVID-19 virus shedding in an immunocompetent COVID-19 patient was 61 days (1-3). In this report, we describe an immunocompetent COVID-19 case in Beijing with 169 days of viral shedding.