臨床感染症と実践

抽象的な

Recurrence or Relapse of COVID 19 Infection

Gary R Skankey and Christopher Breeden

We report a patient, PCR positive for COVID 19, who developed respiratory failure and cytokine release syndrome, recovered after a prolonged period of mechanical ventilation, no longer require supplemental oxygen, and tested negative twice by COVID 19 PCR, relapsed within 40 days of initial infection. Laboratory findings, PO2 and chest radiograph findings were identical to the first episode, and COVID 19 PCR was again positive. Response was significantly better on remdesivir, now available, and the patient recovered with radiographic and respiratory recovery. Serum Covid 19 IgG drawn at the onset of the second episode was positive. This raised a few questions. First, was this a true relapse of infection? Second, if it was, does the IgG detected by the serum study, represent neutralizing antibody and be an indicator of immunity? Third, are there those who develop a weak, or incomplete immune response to the disease?