Study Claims That Close To 17 Percent of Recovered COVID-19 Patients Still Carry Virus, Experts Disagree As Current Test Cannot Detect Virus In Intestines Etc
Recovered COVID-19 patients
are most likely to still have the SARS-CoV-2 coronavirus in them despite being termed as ‘recovered ‘as a result of negative nasal swab PCR test.
A recent research published in the American Journal of Preventive Medicine presents new findings and data that address important questions pertaining to the containment of the coronavirus pandemic: When should COVID-19 quarantine really end and which continuing symptoms may be more indicative of a positive test in recovered patients? https://www.ajpmonline.org/article/S0749-3797(20)30393-7/fulltext
The research was conducted by Italian researchers from Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy, where a multidisciplinary healthcare service was established for all patients who have recovered from COVID-19 to study what happens to them after recovery and to assess the impact of the virus on their bodies.
The study team reported that close to 17 percent of patients considered fully recovered from COVID-19 tested positive for the virus in follow-up screening.
COVID-19 recovered patients who continued to have respiratory symptoms, especially sore throat and rhinitis, were more likely to have a new positive test result. This suggests the persistence of these two symptoms should not be underestimated and should be adequately assessed in all patients considered recovered from COVID-19.
Lead investigator Professor Dr Francesco Landi, MD, Ph.D., Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, and Catholic University of the Sacred Heart, Rome-Italy told Thailand Medical News, "Clinicians and researchers have focused on the acute phase of COVID-19, but continued monitoring after discharge for long-lasting effects is needed."
The research included 131 patients who met the World Health Organization (WHO) criteria for discontinuation of quarantine at least two weeks prior to the follow-up visit.
The current WHO criteria specify that the patient should be fever-free without fever-reducing medications for three days, show improvement in any symptoms related to COVID-19, be more than seven days past symptom onset, and test negative for the SARS-CoV-2 virus twice, at least 24 hours apart, with reverse transcription PCR (RT-PCR) testing.
For the study, a new RT-PCR test was administered at the time of post-acute care admission. Demographic, medical, and clinical information was collected, with an emphasis on the persistence of symptoms and signs related to COVID-19 such as cough, fatigue, diarrhea, headache, smelling disorders, loss of appetite, sore throat, and rhinitis.
It was found that twenty-two (16.7 percent) of the patients tested positive again. There was no significant difference between patients with positive and negative test results in terms of age or sex. None of the patients had fever and all reported improvement in their overall clinical condition. Time since onset of disease, number of days hospitalized, and treatments received while hospitalized were not significant.
Interestingly however, some symptoms such as fatigue (51 percent), labored breathing (44 percent) and coughing (17 percent) were still present in a significant percentage of the patients studied, although there were no significant differences between individuals with a positive or negative test. The only two symptoms that were higher and significantly prevalent in patients with a positive test were sore throat (18 percent vs. 4 percent) and signs of rhinitis (27 percent vs. 2 percent).
The study findings indicate that a noteworthy rate of recovered patients with COVID-19 could still be asymptomatic carriers of the virus," Dr Landi observed
He said, "The main question for the containment of SARS-CoV-2 pandemic infection that still needs to be answered is whether persistent presence of virus fragments means the patients is still contagious. The RT-PCR test looks for small fragments of viral RNA. A positive swab test can reveal if patients are still shedding viral fragments, but it is not able to discern whether they are or aren't infectious."
Significantly, the researchers recommend that for patients who continue to have symptoms potentially related to COVID-19, it is reasonable to be cautious and avoid close contact with others, wear a face mask, and possibly undergo an additional nasopharyngeal swab.
A previous Chinese study however showed that up to 20 percent of recovered patients still had the virus in them
However many researchers are now even questioning these findings and previous guidelines and criteria for considering COVID-19 patients as ‘recovered’ and free from the SAR-CoV-2 coronavirus as the current nasal swab PCR test is not able to detect the virus in the intestines and other organs of the body let alone blood.
Many are speculating that up to 85 % of the COVID-19 recovered COVID-19 patients or more could still be having the virus in them considering the prevalence of a variety of POST-COVID-19 medical conditions such as myocarditis, kidney injury, neurological manifestations and even simply fatigue (the virus still attacking the mitochondria in the cells) in the same numbers of recovered COVID-19 patients.
Numerous individual case reports have emerged of many such patients having the virus still after detailed diagnostics was done as a result of some reported Post-COVID medical conditions.
The virus has now even been detected in the semen male COVI19 patients which nasal swabs are unable to detect. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2765654
Numerous studies have shown infectious SARS-CoV-2 detected in the feces of ‘recovered’ COVID-19 patients. https://onlinelibrary.wiley.com/doi/10.1002/jmv.25795
Case reports have also emerged of recovered COVID-19 patients having the active and infectious SARS-CoV-2 in their blood weeks and months after recovery. https://www.acpjournals.org/doi/10.7326/L20-0725
There are also studies that indicate the virus is able to prime the body’s immune system to accommodate its long term stay. https://www.thailandmedical.news/news/coronavirus-warning-study-reveals-that-after-infection-phase,-the-sars-cov-2-manipulates-human-host-immune-system-to-facilitate-its-long-term-stay
More urgent and detailed studies are needed to understand to what degree of the COVID-19 ‘recovered ‘patients population still have the SARS-Cov-2 in them and how is the virus affecting them. It is also important to know if they can still shed the virus and hence still cause viral spread and transmission.
Better and more accurate diagnostics are also needed and not simply reliance on the nasal swab tests which are proving to be unreliable.
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