Possible COVID-19 recurrence in an older patient: a case report

Background: Novel coronavirus (COVID-19) pandemic cause by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) threatens the world for few months. Few cases of prolonged positivity of viral tests and clinical recurrence of COVID-19 have been described. We report the case of a 78-year-old woman with metastatic breast cancer who developed possible COVID-19 recurrence in a post-acute and rehabilitation unit. Case presentation: A 78-year-old woman with metastatic breast cancer and hypertension developed COVID-19. After symptom improvement and RT-PCR negativation, she regained symptom (fever, fall) and lymphopenia on Day 26 and we note a turned positive RT-PCR even though she was tested positive for antibody against SARS-CoV-2. After the diagnosis of possible COVID-19 recurrence, she was transferred back to an acute “COVID-19” unit and she then quickly clinically recovered. Conclusions: This clinical case allows us to discuss the risk of recurrence and possible specific causes in older patients. Moreover, prolonged symptoms and lymphopenia could be associated to worse outcomes in older patients. Finally, at a collective level, even if traces of virus detected by RT-PCR were not necessarily correlated with the contagiousness, the importance of possible COVID-19 recurrence in the care pathway for older adults must be taken into account, since they are often surrounded by frail older people.