key: cord-0827170-aed6psww
authors: Duggan, Nicole M.; Ludy, Stephanie M.; Shannon, Bryant C.; Reisner, Andrew T.; Wilcox, Susan R.
title: A case report of possible novel coronavirus 2019 reinfection
date: 2020-07-04
journal: Am J Emerg Med
DOI: 10.1016/j.ajem.2020.06.079
sha: fec494dfd16a1654f55cfa34f63487fef4a5f8f2
doc_id: 827170
cord_uid: aed6psww

Since December 2019, COVID-19, the clinical syndrome associated with SARS-CoV-2 infection, has infected more than 6.2 million people and brought the function of the global community to a halt. As the number of patients recovered from COVID-19 rises and the world transitions toward reopening, the question of acquired immunity versus the possibility of reinfection are critical to anticipating future viral spread. Here, we present a case of a patient previously recovered from COVID-19 who re-presents with new respiratory, radiographical, laboratory, and RT-PCR findings concerning for re-infection. We review this case in the context of the evolving discussion and theories surrounding dynamic RT-PCR results, prolonged viral shedding, and the possibility of developed immunity.

First discovered in December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated clinical syndrome (COVID-19) became a global pandemic over a few short months [1, 2] . According to the World Health Organization recommendations, patients infected with COVID-19 may safely discontinue home isolation and are considered non-infectious after complete symptomatic recovery in addition to two negative real-time reverse-transcription polymerase chain reaction (RT-PCR) tests for SARS-CoV-2 drawn at least 24 hours apart [3] . However, recent reports of patients re-testing positive even after resolved symptoms and negative testing raise questions about the possibility of reinfection [4] [5] [6] [7] . Here, we present a case of possible SARS-CoV-2 reinfection, and discuss this case in the context of the existing debate surrounding dynamic RT-PCR results.

An 82-year-old male with a history of advanced Parkinson's disease, insulin-dependent diabetes, chronic kidney disease, and hypertension presented to the emergency department (ED) in early-April 2020 with one week of fever and shortness of breath. He was hemodynamically stable, but tachypneic, hypoxic to 89% on six liters of oxygen via nasal cannula, and febrile to 100.4F. Chest x-ray revealed peripheral and basilar patchy opacities concerning for COVID-19 ( Figure 1A 

Here, we discuss a case of suspected COVID-19 reinfection in the context of the growing body of 

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