Rare coronavirus patient's mild symptoms but long illness may point to 'chronic' mutation

[LovingA2andMI]

South China Morning Post

"Chinese researchers have raised the possibility that a new subtype pathogen of Covid-19 that has low toxicity but with prolonged ability to infect others might have occurred after observing a rare case in which the disease appeared to be “chronic”, pointing to the possibility of a mutation.

The researchers warn there may be more “chronic infected patients” who carry the infection into their surroundings and trigger an outbreak.

A middle-aged man whose symptoms were not severe appears to have formed a “dynamic balance” with the coronavirus after an extremely prolonged illness lasting 49 days, Chinese military researchers reported in a preprint article on Medrxiv.org last week.
The patient had been observed to have both a high Covid-19 viral load and, at the same time, his immune cell indicators had remained stable.

“The virus and the host may even form a symbiotic relationship,” said the researchers from the Army Medical University in Chongqing, No 967 Hospital of PLA, Dalian, and General Hospital of the PLA Central Theatre Command in Wuhan.

As the signs showed that his body could not eliminate the coronavirus with regular therapy and that he might still have been infectious, the patient was treated with a plasma transfusion from recovered Covid-19 patients.

The man’s swabs turned negative two days later.

It was, to date, the longest known duration of “viral shedding” for a patient who survived Covid-19. Previous clinical observation showed the median time of surviving patients turning negative was 20 days, with the longest case at 37 days. Usually, the longer the duration is, the more severe the case.

This patient, however, had intermittent low fever and did not have a cough, chill, shortness of breath or other typical Covid-19 symptoms. CAT imaging of the patient showed infection lesions on bilateral lungs, which disappeared a few days after he was admitted to hospital, and his body temperature also returned to normal, the researchers found.

The patient’s nucleic acid test for Covid-19 remained positive with a consistently high viral load similar to those of severe or critical cases, which suggested a prolonged infective ability.

The case “may tend to be a chronic infected case without transfusion treatment”, the researchers said.

An elderly woman related to the patient also tested positive for Covid-19 and showed moderate symptoms. However, despite the higher risk associated with her age and pre-existing conditions, she had a faster recovery and a better prognosis than the average of others her age.

The epidemiological survey found no other positive results among the family cluster’s close contacts.

https://www.scmp.com/news/china/society/article/3077747/rare-coronavirus-patients-mild-symptoms-long-illness-may-point

[Lochloosa]

1. Oh great.

[lapfog_1]

2. oh man... this is really bad news

[2naSalit]

3. Lovely.

[cayugafalls]

4. I do not like this virus one bit. It's mutations may be with us for a long time.

It seems to me that vaccines are going to have to evolve each year just like the flu vaccine in order to remain viable, I could be wrong, I hope i am wrong.

[gristy]

5. It would seem more likely that this individual's response is simply within the range of

possible response of the general population to the same virus.

[greenjar_01]

6. I'm honestly not taking any of these "weird finding" news items seriously

Until we have clear studies in medical journals that have been peer-reviewed. All they lead to is the old "I read somewhere that..." nonsense that confuses people and serves as little more than faux expertise for people who like hearing the sound of their own voice.

We need expert information, but expert information requires transparent vetting. The South China Morning Post ain't it.

[LovingA2andMI]

7. Michigan woman with coronavirus develops rare complication affecting brain

DETROIT FREE PRESS

A 58-year-old woman hospitalized in the Henry Ford Health System who has the new coronavirus developed a rare complication: encephalitis.

In a case report published online Tuesday in the journal Radiology, a team of doctors say the woman tested positive for the coronavirus, but also developed a case of acute necrotizing encephalitis, or ANE, a central nervous infection that mostly afflicts young children.

It is believed to be the first published case linking COVID-19 and acute necrotizing encephalitis. The rare and serious brain disease can develop in people who have a viral infection, and causes lesions to form in the brain, tissue death and symptoms such as seizures, drowsiness, confusion and coma.

The woman, who was identified as an airline worker, had several days of fever, cough and muscle aches, and was taken by ambulance March 19 to a Henry Ford emergency room, said Dr. Elissa Fory, a Henry Ford neurologist.

The patient also showed signs of confusion, lethargy and disorientation. A flu test turned up negative but a rapid COVID-19 test, developed in-house by Henry Ford’s clinical microbiology lab, confirmed she had the coronavirus, Fory said.

When the woman remained lethargic, doctors ordered repeat CT and MRI scans, which revealed abnormal lesions in both thalami and temporal lobes, parts of the brain that control consciousness, sensation and memory function. These scans confirmed doctors’ early suspicions.

“The team had suspected encephalitis at the outset, but then back-to-back CT and MRI scans made the diagnosis,” Fory said in a news release.

“This is significant for all providers to be aware of and looking out for in patients who present with an altered level of consciousness. We need to be thinking of how we’re going to incorporate patients with severe neurological disease into our treatment paradigm. This complication is as devastating as severe lung disease.”

https://www.freep.com/story/news/health/2020/04/01/michigan-coronavirus-complication-encephalitis/5103698002/