A Low Viral Dose in COVID-19 Patient: A Case Report

Yajuan Li; Xianwei Hu; Youhui Tu; Tao Wu; Bo Wang; Huan Ma; Weihong Zeng; Dan Zhao; Hylemariam Mihiretie Mengist; Arnaud John Kombe Kombe; Meijuan Zheng; Yuanhong Xu; Tengchuan Jin

doi:10.3389/fpubh.2020.00339

A Low Viral Dose in COVID-19 Patient: A Case Report

Front Public Health. 2020 Jun 26:8:339. doi: 10.3389/fpubh.2020.00339. eCollection 2020.

Authors

Yajuan Li¹, Xianwei Hu², Youhui Tu², Tao Wu³, Bo Wang¹, Huan Ma⁴, Weihong Zeng⁴, Dan Zhao⁴, Hylemariam Mihiretie Mengist⁴, Arnaud John Kombe Kombe⁴, Meijuan Zheng¹, Yuanhong Xu¹, Tengchuan Jin^{4

5

6}

Affiliations

¹ Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
² Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
³ Department of Nuclear Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
⁴ Hefei National Laboratory for Physical Sciences at Microscale, Laboratory of Structural Immunology, CAS Key Laboratory of Innate Immunity and Chronic Disease, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
⁵ Division of Molecular Medicine, Division of Life Sciences and Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.
⁶ CAS Center for Excellence in Molecular Cell Science, Chinese Academy of Science, Shanghai, China.

Abstract

SARS-CoV-2 outbreak has attracted global attention. Verifying the presence of viral RNA is the gold standard for the diagnosis of COVID-19. However, RT-qPCR diagnosis often fails to catch infected patients, because of inconsistent swab sample collection. Here we report a case that showed 5 consecutive negative and 1 low-viral- dose RT-qPCR results during illness spanning over 20 days. Clinical symptoms suggest SARS-CoV-2 infection with typical ground glass like a lung in computed tomography. SARS-CoV-2 infection was serologically confirmed by the presence of anti-SARS-CoV-2 specific antibodies in patients' serum. Finally, a high level of protective IgG was produced after the patient recovered. Surprisingly, as a barber and a housewife staying at home for the first 2 weeks after the onset of illness, none of the close contacts were infected, showing a case of low viral load and low infectivity in this patient.

Keywords: COVID-19 patient; IgA; IgG; IgM; RT-qPCR.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Humans
RNA, Viral / genetics
SARS-CoV-2
Serologic Tests
Viral Load

Substances

RNA, Viral