Discontinuation of quarantine of the patient infected with SARS-CoV-2 over 100 days

Abstract

I read with great interest the recently published article by Abe et al., entitled ‘A patient infected with SARS-CoV-2 over 100 days’, in the current issue of QJM: An International Journal of Medicine. As a clinician, struggling with this chaotic pandemic, I was encouraged and informed a lot by this case. This report was remarkable not only because they demonstrated the first case of viral isolation by culture in a long-hauler. In addition, they also indicated the difference in sensitivity of polymerase chain reaction (PCR) by specimen types as well as the possibility of temporary negative conversion of sequential tests, using a real case. However, their decision-making process of quarantine discontinuation was not clear. In order to save limited resources, manpower and also to avoid unnecessarily prolonged restrictions, clinical improvement has been emphasized over the results of PCR tests when discontinuing precautions. Although in these sorts of long-haulers cases, clinical courses of improvement should have presumably been gradual. As shown in the table, the PCR test immediately before the discontinuation of quarantine was positive. Ultimately, their decision was appropriate since no health care personnel became infected following. Clarifying what clinical factors specifically led to the release of quarantine in this long-term case will be of great help to many other clinicians, who are also struggling with this current pandemic.