Prolonged Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA in an Obstetric Patient With Antibody Seroconversion

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 136; no. 4; pp. 838 - 841
• Main Authors: Molina, Loren P, Chow, Siu-Kei, Nickel, Adam, Love, Jason E
• Format: Journal Article
• Language: English
• Published: United States by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01.10.2020
• Subjects: Adult; Antibodies, Viral - blood; Betacoronavirus - immunology; Betacoronavirus - isolation & purification; Clinical Laboratory Techniques - methods; Coronavirus Infections - diagnosis; Coronavirus Infections - immunology; COVID-19; COVID-19 Testing; Female; Gestational Age; Humans; Monitoring, Immunologic - methods; Pandemics; Pneumonia, Viral - diagnosis; Pneumonia, Viral - immunology; Pregnancy; Pregnancy Complications, Infectious - diagnosis; Pregnancy Complications, Infectious - immunology; SARS-CoV-2; Seroconversion - physiology; Time Factors; Virus Shedding - immunology
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/AOG.0000000000004086

BACKGROUND:There is a growing understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) in the general population. The unique immunology of pregnancy may result in variations from the reported course of disease. CASE:A 27-year-old primigravid woman presented with mild COVID-19 symptoms at 28 2/7 weeks of gestation, testing positive for SARS-CoV-2 infection by nasopharyngeal swab reverse transcription-polymerase chain reaction (RT-PCR). Antibody seroconversion was detected at 36 6/7 weeks of gestation. She presented for delivery at 38 1/7 weeks of gestation, and her SARS-CoV-2 RT-PCR test result was positive. Severe acute respiratory syndrome coronavirus 2 RNA remained detectable 34 days postpartum and 104 days from her initial positive test. CONCLUSION:Prolonged viral shedding of SARS-CoV RNA may occur in the pregnant patient. If prevalent, this complicates the interpretation of a positive SARS-CoV-2 RT-PCR test result in the asymptomatic gravid patient.