Symptomatic relapse and long-term sequelae of COVID-19 in a previously healthy 30-year-old man

Much has been reported on the clinical course of severe COVID-19, but less is known about the natural history and sequalae of mildly symptomatic cases and the prospects of reinfection or recurrence of symptoms. We report a case of a patient with mildly symptomatic PCR-confirmed COVID-19 who, after being symptom-free for 2 weeks, redeveloped symptoms and was found to be PCR-positive again >4 weeks from original testing. Surprisingly, IgG and IgM antibody testing was negative 2 months after reinfection. Although no negative testing was performed between the two symptomatic bouts, this case raises the possibility of reinfection after controlling the virus and highlights the long period with which a patient can shed virus and experience symptoms after initial infection. Characterising variations in clinical symptoms and length of viral shedding after improvement is essential for informing recommendations on patients safely resuming contact with others.

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Clinical characteristics and outcomes of COVID-19 long-term nucleic acid positive patients

Technology and Health Care ◽

10.3233/thc-212921 ◽

2021 ◽

pp. 1-10

Author(s):

Xuan Zhu ◽

Xinxin Zhu ◽

Min Wang ◽

Fang Yang ◽

Zhibing Sun ◽

...

Keyword(s):

Nucleic Acid ◽

Clinical Characteristics ◽

Clinical Symptoms ◽

Control Group ◽

Viral Shedding ◽

Imaging Characteristics ◽

And Gender ◽

Acid Test ◽

Pulmonary Ct

OBJECTIVE: This study aimed to investigate the clinical characteristics and outcomes of coronavirus disease-19 (COVID-19) long-term nucleic acid positive patients (hereinafter referred to as CLTAPs). METHODS: Patients were recruited from the Xiaogan Central Hospital between 16 January 2020 and 28 March 2020. Among the 562 cases of patients with laboratory-identified COVID-19 infection by real-time polymerase chain reaction (qtPCR), 19 cases of COVID-19 patients with more than 41 days from the first to the last time of nucleic acid test were selected as the study group, and 76 cases of age- and gender-matched COVID-19 patients were selected as the control group (hereinafter referred to as C-CLTAPs). Demographic characteristics, clinical symptoms, laboratory examination and computed tomography (CT) imaging characteristics were retrospectively analyzed. RESULTS: On admission, among the 562 cases of patients with COVID-19, there were 398 cases of ordinary COVID-19 patients, 99 cases of severe COVID-19 patients and 99 cases of critical COVID-19 patients. CLTAPs had milder clinical symptoms and longer viral shedding time in comparison to C-CLTAPs. Compared to C-CLTAPs, CLTAPs had a lower infection index at admission. CLTAPs used less oxygen therapy and a higher proportion of hydroxychloroquine treatment in comparison to C-CLTAPs. In comparison to C-CLTAPs, CLTAPs showed slower pulmonary CT progression and faster pulmonary CT absorption. CONCLUSION: In this study, out of the 562 cases, we found 19 CLTAPs. The clinical differences between CLTAPs and C-CLTAPs were compared and analyzed. We hope that these finding can provide a theoretical basis for the treatment of CLTAPs.

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Natural history and long-term clinical course of Crohn’s disease

World Journal of Gastroenterology ◽

10.3748/wjg.v20.i1.31 ◽

2014 ◽

Vol 20 (1) ◽

pp. 31 ◽

Cited By ~ 56

Author(s):

Hugh James Freeman

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Natural History ◽

Clinical Course

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The Long-Term Clinical Course of Canine Degenerative Myelopathy and Therapeutic Potential of Curcumin

Veterinary Sciences ◽

10.3390/vetsci8090192 ◽

2021 ◽

Vol 8 (9) ◽

pp. 192

Author(s):

Yui Kobatake ◽

Kohei Nakata ◽

Hiroki Sakai ◽

Jun Sasaki ◽

Osamu Yamato ◽

...

Keyword(s):

Clinical Symptoms ◽

Clinical Course ◽

Therapeutic Potential ◽

Late Onset ◽

Respiratory Disorder ◽

Limited Information ◽

Respiratory Impairment ◽

Degenerative Myelopathy ◽

End Stage

Canine degenerative myelopathy (DM), recognized as a spontaneous model of amyotrophic lateral sclerosis, is known as a late-onset progressive degenerative disease of the spinal cord. Because of the progressive nature of DM, many dogs are elected to be euthanized, resulting in limited information on the end-stage clinical presentation. We investigated the long-term clinical course from diagnosis to natural death to further deepen our understanding of the entire clinical picture of this disease. Because curcumin was administered in some cases, the therapeutic effect of curcumin on DM was also examined. Forty dogs included in this study were client-owned Pembroke Welsh Corgis with a definitive diagnosis of DM by necropsy and histopathology. Dogs were excluded from this study if they died from another disease or were elected to be euthanized. Information on the long-term clinical symptoms of DM was investigated based on a questionnaire, which was collected from the dog owners. Urinary incontinence and respiratory disorder were observed in most dogs, as was respiratory impairment-correlated death. In contrast, signs consistent with brainstem dysfunction were noticed at the terminal stage in a small portion of dogs. Although further studies with more cases are needed, the results of this study suggest that administration of curcumin is effective in slowing the progression of DM.

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Positive SARS-CoV-2 RNA recurs repeatedly in a case recovered from COVID-19: dynamic results from 108 days of follow-up

Pathogens and Disease ◽

10.1093/femspd/ftaa031 ◽

2020 ◽

Vol 78 (4) ◽

Cited By ~ 6

Author(s):

Fang Liu ◽

Zhao-bin Cai ◽

Jin-song Huang ◽

Wen-yan Yu ◽

Hai-ying Niu ◽

...

Keyword(s):

Lipid Metabolism ◽

Liver Function ◽

Serum Lipid ◽

Clinical Symptoms ◽

Viral Shedding ◽

Clinical Presentations ◽

Atypical Presentations ◽

Observation Period

ABSTRACT The evidence of long-term clinical dynamic on Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA re-positive case are less. We performed a 108 days follow-up on dynamic clinical presentations in a case, who hospitalized three times due to the positive recurrence of SARS-CoV-2 RNA after discharge, to understand the prognosis of the 2019-Coronavirus disease (COVID-19). In this case, positive SARS-CoV-2 recurred even after apparent recovery (normal CT imaging, no clinical symptoms, negative SARS-CoV-2 on stool sample and negative serum IgM test) from COVID-19, viral shedding duration lasted for 65 days, the time from symptom onset to disappearance was up to 95 days. Erythrocyte-associated indicators, liver function and serum lipid metabolism presented abnormal throughout during the observation period. Awareness of atypical presentations such as this one is important to prompt the improvement of the management of COVID-19.

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The Natural History, Clinical Course, and Long-Term Recovery from Opioid Use Disorders

Treating Opioid Addiction - Current Clinical Psychiatry ◽

10.1007/978-3-030-16257-3_9 ◽

2019 ◽

pp. 181-196 ◽

Cited By ~ 2

Author(s):

Elizabeth A. Evans ◽

Yih-Ing Hser

Keyword(s):

Natural History ◽

Clinical Course ◽

Opioid Use ◽

Opioid Use Disorders

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Myelomeningocele with Associated Anomalies – Case Report and Literature Review

Folia Medica ◽

10.3897/folmed.61.e39415 ◽

2019 ◽

Vol 61 (3) ◽

pp. 462-466

Author(s):

Borislav Kitov ◽

Ivo Kehayov

Keyword(s):

Literature Review ◽

Chiari Malformation ◽

Clinical Symptoms ◽

Associated Anomalies ◽

Long Period ◽

The Central Nervous System ◽

Cns Malformations ◽

Current Report ◽

Common Defect

Myelomeningocele is a common defect of the development of the neural tube. It is a complex congenital malformation of the central nervous system (CNS) that can be associated with other concurrent anomalies. We report on a case of lumbar myelomeningocele with concomitant CNS malformations we followed up over a period of 15 years. A concise literature review has also been performed. The current report illustrates that the myelomeningocele is a complex anomaly that is commonly associated with a variety of other CNS malformations such as hydrocephalus and Chiari malformation. It may follow chronic progressive course with exacerbation of clinical symptoms in the long term. Patients that have undergone surgical correction of this spinal defect should be closely monitored over a long period of time because of the possibility of clinical deterioration of the concomitant anomalies such as hydrocephalus, Chiari malformation and siryngomyelia.

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Reduction of major amputations in the diabetic ischaemic foot: A strategy to "take control" with conservative care as well as revascularisation

VASA ◽

10.1024/0301-1526.30.s58.6 ◽

2001 ◽

Vol 30 (Supplement 58) ◽

pp. 6-14 ◽

Cited By ~ 13

Author(s):

Edmonds ◽

Foster

Keyword(s):

Natural History ◽

Treatment Plan ◽

Staging System ◽

Vascular Control ◽

New Approach ◽

Conservative Care ◽

Arterial Bypass ◽

Therapeutic Footwear ◽

Frequent Problem

The diabetic ischaemic foot has become an increasingly frequent problem over the last decade. However, we report a new approach consisting of a basic classification, a simple staging system of the natural history and a treatment plan for each stage, within a multi-disciplinary framework. This approach of "taking control" consists of two parts: 1. long-term conservative care including debridement of ulcers (to obtain wound control), eradication of sepsis (micribiological control), and provision of therapeutic footwear (mechanical control), and 2. revascularisation by angioplasty and arterial bypass (vascular control). This approach has led to a 50% reduction in the rate of major amputations in patients attending with ischaemic ulceration and absent foot pulses from 1989 to 1999 (from 4.6% to 2.3% per year). Patients who underwent angioplasty increased from 6% to 13%. Arterial bypass similarly increased from 3% to 7% of cases. However, even with an increased rate of revascularisation, 80% of patients responded to conservative care alone. This,we conclude, is an essential part of the management of all patients with ischaemic feet.

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Adenoid Cystic Carcinoma of Lacrimal Gland

JMS SKIMS ◽

10.33883/jms.v15i1.124 ◽

2012 ◽

Vol 15 (1) ◽

pp. 76-77

Author(s):

Mohd Athar ◽

K S Sodhi ◽

S Kala ◽

R K Maurya ◽

S Chauhan ◽

...

Keyword(s):

Local Recurrence ◽

Natural History ◽

Adenoid Cystic Carcinoma ◽

Salivary Glands ◽

Hard Palate ◽

Clinical Course ◽

Fatal Outcome ◽

Minor Salivary Glands ◽

Adenoid Cystic ◽

History Of

Adenoid cystic carcinoma is a relatively uncommon tumour of salivary, glands and is characterised by a prolonged clinical course and a fatal outcome. It was first described as `cylindroma' by Billroth in 1859. Half of these tumors occur in glandular tissues other than the major salivary glands; principally in the hard palate, but they can also arise in the tongue and minor salivary glands. Unusual locations include the external auditory canal, nasopharynx, lacrimal glands, breast, vulva, esophagus, cervix and Cowper glands. The long natural history of this tumor and its tendency for local recurrence are well known. JMS 2012;15(1):76-77.

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