case_images: PMC10874686_01
case_images: A series of chest computed tomography (CT) images of the patient with Good syndrome with recurrent COVID-19.. Denotes the number of days after symptom onset. A. On day 42, extensive ground-glass opacities (GGOs) and consolidation were observed in both lungs. B. On day 61, the GGOs and consolidation improved after the administration of remdesivir, corticosteroids, and tocilizumab. C. On day 65, new GGOs emerged bilaterally. D. On day 79, only a few patchy GGOs remained at the time of discharge. E. On day 272, various abnormal shadows, such as reticulonodular shadows and bronchiectasis, were observed. Moreover, new consolidations and GGOs emerged. F. On day 300, the patient's respiratory condition improved, and most GGOs had turned into reticular shadows.
case_images: cureus-0016-00000052592-i01.jpg
case_images: PMC10874686_01_cureus-0016-00000052592-i01.jpg
case_images: FIG1
case_images: Chest CT showed extensive diffuse consolidation and GGOs (Figure 1A). His respiratory condition and GGOs on chest CT showed improvement (Figure 1B); therefore, the corticosteroid dose was tapered. However, his respiratory condition gradually deteriorated, and new GGOs emerged in subsequent CTs (Figure 1C). Remdesivir was restarted without immunosuppressants or steroids, and his respiratory condition and GGO levels improved (Figure 1D). On day 272, the patient returned to our hospital (third hospitalization) with dyspnea and mild fever (Figure 1E). His respiratory condition improved (Figure 1F), and the SARS-CoV-2 qRT-PCR test quickly turned negative.
case_images: The clinical course of the 40-year-old male patient with recurrent SARS-CoV-2 infection.. A. The upper panel shows the clinical course of the patient. Black squares, red circles, and blue stars indicate Cq values, IgG-S, and CT scans, respectively. SARS-CoV-2 positivity (qRT-PCR) is indicated in the upper part of the graph by a + (positive) or - (negative) sign. Each treatment regimen is indicated in the upper part of the graph by horizontal lines. The bottom panel represents the number of daily new cases of SARS-CoV-2 infections in Japan. B. Phylogenetic analysis was performed using patient-derived sequences (blue circle, n = 4) and sequences derived from the GISAID database (yellow circle, n = 778). The branch length corresponds to nucleotide divergence. A cluster of patient-derived sequences is enlarged in the lower right frame.. Cq: quantification of cycle; GISAID: Global Initiative on Sharing All Influenza Data
case_images: cureus-0016-00000052592-i02.jpg
case_images: PMC10874686_01_cureus-0016-00000052592-i02.jpg
case_images: FIG2
case_images: All Influenza Data (GISAID) database. All patient-derived sequences were tightly clustered together in the tree, but the sequence on day 272 had a longer branch length, indicating that multiple mutations had accumulated in the genome (Figure 2B).