Coronavirus, 2 days of cough, but 9-year-old remains positive (and isolated) for months

On April 20 a little cough and runny nose, in the afternoon of the 21 the fever at 38.3, in the afternoon of the 22 nothing more. For a 9 year old, COVID-19 gave a sign of himself like this: few symptoms, as in fact already certified by several studies on the little ones. Everything in the norm, except one fact: the very young patient collected positive swabs for 12 weeks. Thus, it remained positive for the Sars-CoV-2 coronavirus for almost 3 months, 82 days to be exact, with the first negative swab recorded only on August 4 and the second on August 6.

The case reported by a team of Italian doctors is the protagonist of a scientific study published in Infection diary. In their work, the authors explain that the story of the child who remained positive for so long “suggests that an exceptionally high viral load can be detected in paucisymptomatic children and, consequently, the elimination of the virus can take a long time.” Therefore, the duration of infectivity should be established to avoid these patients being forced to long isolation although they are no longer infectious.

“There are more reports of prolonged viral spread in people infected with Sars-CoV-2, but, the authors note, the presence of viral RNA in a test is not necessarily related to infectivity.”

An important issue to explore, given the impact on the definition of the necessary quarantine times also in view of the reopening of schools.

Coronavirus, the case of “positive” children for 3 months

The baby-patient at the center of the study is a child with a form of autism and intellectual disability, a guest at Villa Santa Maria, a multi-service center for child and adolescent neuropsychiatry based in Tavernerio, in the province of Como. The authors are gowns White House of the Foundation, Enzo Grossi and Vittorio Terruzzi. His work adds more data to one of the hottest ‘chapters’ these days: Covid-19 and the very young.

“Until now, few studies have focused on the duration of detection of Covid-19 in asymptomatic or paucisymptomatic subjects. In asymptomatic adults, the median time from the first positive test to the first of two consecutive negative samples is between 7 and 23 days. Only two clinical case studies concerned children, with detectable virus for 10 days and for 17 days. “

The case of the 9-year-old boy lengthens the time. This is a case of “exceptionally high viral load” and slow shedding of viral RNA. When the baby showed mild symptoms consistent with the disease, he underwent tests and the physical examination showed no clinical signs of lung involvement. The swab performed on April 24 was positive. And so the following for several weeks and the subject remained isolated throughout the period, in which, however, he always remained asymptomatic.

The bottom line, experts explain, is that “Regardless of whether or not they have exhibited symptoms of Covid-19 infection, children and young people who have been affected by the coronavirus can test positive on the nasopharyngeal smear for periods of up to three months.“, as in the case of the 9-year-old boy, due to the extremely high initial viral load.

Coronavirus, the importance of viral load

That of viral load, or the concentration of the virus in the body is a very delicate and often overlooked aspect: we usually limit ourselves to defining whether a subject is positive or negative for Covid-19, but in the context of the so-called positivity the viral load values they can vary by more than 10 orders of magnitude, and this can make a big difference in modulating the intensity of the precautions to be taken.