Abstract Inpatient coronavirus disease 2019 (COVID‐19) cases present enormous costs to patients and health systems in the United States. Many hospitalized patients may continue testing COVID‐19 positive even after the resolution of symptoms. Thus, a pressing concern for clinicians is the safety of discharging these asymptomatic patients if they have any remaining infectivity. This case report explores the viral viability in a patient with persistent COVID‐19 over the course of a 2‐month hospitalization. Positive nasopharyngeal swab samples were collected and isolated in the laboratory and analyzed by quantitative reverse‐transcription polymerase chain reactions (qRT‐PCR), and serology was tested for neutralizing antibodies throughout the hospitalization period. The patient experienced waning symptoms by hospital day 40 and had no viable virus growth by hospital day 41, suggesting no risk of infectivity, despite positive RT‐PCR results which prolonged his hospital stay. Notably, this case showed infectivity for at least 24 days after disease onset, which is longer than the discontinuation of transmission‐based precautions recommended by the Center for Disease Control and Prevention. Thus, our findings suggest that the timeline for discontinuing transmission‐based precautions may need to be extended for patients with severe and prolonged COVID‐19 disease. Additional large‐scale studies are needed to draw definitive conclusions on the appropriate clinical management for these patients. Highlights A patient with severe COVID‐19 disease demonstrated infectivity at least 24 days after disease onset, which is longer than the current discontinuation of transmission‐based precautions guidelines in the United States. The patient had no viable virus growth by hospital day 41, suggesting no risk of infectivity despite a positive RT‐PCR test result. Our findings suggest that the timeline for discontinuation of transmission‐based precautions may require an extension for patients with severe and prolonged COVID‐19 illness.
【저자키워드】 COVID‐19, SARS‐CoV‐2, Patient discharge, Inpatients, real‐time polymerase chain reaction, 【초록키워드】 coronavirus disease, neutralizing antibody, Hospitalization, serology, hospital, prevention, Symptom, Case report, Laboratory, COVID‐19, polymerase chain reaction, viability, Patient, Control, Clinical management, health system, disease, Precaution, Quantitative, patients, asymptomatic patient, disease onset, Hospital stay, Inpatient, no risk, clinician, center, extension, positive, nasopharyngeal swab sample, virus growth, RT‐PCR, RT‐PCR test, The United States, Course, analyzed, collected, hospitalized patient, demonstrated, had no, resolution of symptoms, was tested, 【제목키워드】 COVID‐19, RNA, SARS‐CoV‐2, Patient, Stage,