A few weeks ago, we reported on several Reddit threads where COVID-19 patients from around the world - many of them young men - shared their struggles with a virus that they just couldn't seem to shake. Some patients who were six or seven weeks post-confirmation (meaning they probably had contracted the virus two months earlier, or possibly even longer) complained of symptoms coming back in waves, while others complained that they were still testing positive for the virus weeks after their symptoms disappeared.
Though rare, these cases have alarmed researchers who fear that some patients might become chronic carriers of the virus. And the scientists leading China's response to the outbreak are particularly concerned about dozens of apparently chronic patients in Hubei who still haven't cleared the virus, even as the region - which was bolted shut during the outbreak crisis - slowly reopens to the outside world.
According to Chinese business newswire Caixin, more than 30 patients in Hubei Province have seemingly recovered from COVID-19, but continue to test positive, said Jiao Yahui, an inspector at the National Health Commission, in an April 24 interview with the state broadcaster.
Typically, patients infected with COVID-19 will test negative on nucleic acid throat swabs roughly 20 days after detection. However, for a small number of patients, throat swabs will produce positive tests for more than 40 days. Some patients are still producing positive swabs, despite being infected in the first wave of patients.
Of course, the existence of patients who still test positive raises the question of whether they are still infectious. It's certainly possible that these tests might be picking up errant pieces of genetic material leftover from the infection, but it's also possible that the virus could have burrowed deep enough to become chronic, though, as scientists say, that's not 'typical' behavior for a naturally occurring coronavirus.
Hold that thought.
Scientists say there's "little possibility" that humans can be lifelong carriers of this virus. But it's not impossible.
Whatever the reality might be, infectious disease experts in China are recommending that these patients be kept in isolation in what we imagine has become a singularly hellish experience for these unfortunate patients.
Whether this is evidence of chronic infection, or simply an extended process of "viral shedding", the issue has perplexed some of China's greatest virologists.
Doctors in China and abroad are puzzled by some patients’ longer process of of viral shedding. In late March, a preprint essay by Wuhan military doctors Wang Qingshu and Niu Hongming discussed a patient who remained positive in virus tests for 49 days.
The patient, a middle-aged male, showed fever and other symptoms Jan. 25 but recovered after a week of medication. He tested positive for the virus Feb. 8 after one of his family members was confirmed with the infection. The man took nine nucleic acid tests in the following weeks, and only one test on March 11 showed negative.
He also received two antibody tests in late February and mid-March, reading positive for one form of immunoglobulin but negative for another. Such results suggest that the infection has lingered for a while and faded from the acute phase, the doctors wrote.
The patient received plasma therapy March 15, which involves transfusing antibody-rich blood components into patients. He had high fever hours after the infusion, but his temperature returned to normal the next day. His virus tests on the following two days turned negative.
"Without plasma therapy, this patient may turn to a chronic infection case," the doctors wrote in the paper. "We want to know how many patients have similar situations.” The authors said they were unable to conclude whether such patients could infect others or how long their infections could last."
The patient was part of a family cluster, the researchers wrote. One of his infected family members, an elderly female, also took a longer-than-normal period to test negative. The authors said the cases suggested that family-cluster infections may be less virulent but lead to longer periods for patients to resolve the virus.
What was that again about SARS-CoV-2 being a "man made" virus?