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Assessment of SARS-CoV-2 RNA Test Results Among Patients Who Recovered From COVID-19 With Prior Negative Results

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To identify the key insights or developments described in this article
1 Credit CME

Some patients who have recovered from coronavirus disease 2019 (COVID-19) with documented negative real-time polymerase chain reaction (RT-PCR) results at the time of recovery have had subsequent positive RT-PCR test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)1,2 in the absence of any symptoms suggestive of new infection.3 It is unknown whether such patients are infectious and whether they should be quarantined. Real-time PCR is not a viral culture and does not allow determination of whether the virus is viable and transmissible. We investigated RT-PCR retested positive nasal/oropharyngeal swab (NOS) samples from recovered patients with COVID-19 with prior negative results for the presence of replicative SARS-CoV-2 RNA.4

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Article Information

Accepted for Publication: October 25, 2020.

Published Online: November 12, 2020. doi:10.1001/jamainternmed.2020.7570

Corresponding Author: Brunella Posteraro, PhD, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy (brunella.posteraro@unicatt.it).

Author Contributions: Drs Sanguinetti and Cattani had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Liotti and Menchinelli contributed equally to the study. Drs Sanguinetti and Cattani contributed equally as senior authors.

Concept and design: Liotti, Posteraro, Landi, Sanguinetti, Cattani.

Acquisition, analysis, or interpretation of data: Liotti, Menchinelli, Marchetti, Posteraro, Sanguinetti, Cattani.

Drafting of the manuscript: Liotti, Menchinelli, Posteraro, Sanguinetti, Cattani.

Critical revision of the manuscript for important intellectual content: Liotti, Marchetti, Landi, Sanguinetti, Cattani.

Statistical analysis: Menchinelli.

Obtained funding: Sanguinetti.

Supervision: Posteraro, Landi.

Other: Liotti.

Conflict of Interest Disclosures: None reported.

Funding/Support: This work was funded by donations from Reale Group and Fondazione Valentino Garavani & Giancarlo Giammetti to support the COVID-19 research in our institution.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank Franziska Lohmeyer, PhD (Scientific Direction, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy) for English revision of the manuscript. She was not compensated for her contributions.

References
1.
Lan  L , Xu  D , Ye  G ,  et al.  Positive RT-PCR test results in patients recovered from COVID-19.   JAMA. 2020;323(15):1502-1503. doi:10.1001/jama.2020.2783 PubMedGoogle ScholarCrossref
2.
Kang  H , Wang  Y , Tong  Z , Liu  X .  Retest positive for SARS-CoV-2 RNA of “recovered” patients with COVID-19: Persistence, sampling issues, or re-infection?   J Med Virol. 2020;1-3. doi:10.1002/jmv.26114PubMedGoogle Scholar
3.
Alvarez-Moreno  CA , Rodríguez-Morales  AJ .  Testing dilemmas: post negative, positive SARS-CoV-2 RT-PCR—is it a reinfection?   Travel Med Infect Dis. 2020;35:101743. doi:10.1016/j.tmaid.2020.101743 PubMedGoogle Scholar
4.
Wölfel  R , Corman  VM , Guggemos  W ,  et al.  Virological assessment of hospitalized patients with COVID-2019.   Nature. 2020;581(7809):465-469. doi:10.1038/s41586-020-2196-x PubMedGoogle ScholarCrossref
5.
Carfì  A , Bernabei  R , Landi  F ; for the Gemelli Against COVID-19 Post-Acute Care Study Group.  Persistent symptoms in patients after acute COVID-19.   JAMA. 2020;324(6):603-605. doi:10.1001/jama.2020.12603 PubMedGoogle ScholarCrossref
6.
Gemelli Against COVID-19 Post-Acute Care Study Group.  Post-COVID-19 global health strategies: the need for an interdisciplinary approach.   Aging Clin Exp Res. 2020;32(8):1613-1620.Google Scholar
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