Prolonged SARS-CoV-2 RNA detection in nasopharyngeal RT-PCR test in
COVID-19 patients with Myelodysplastic Syndrome: A case report
Dr. Hasan Dirik
Ankara City Hospital, Intensive
Care Unit, Ankara, Turkey. e-mail: hsndrk_38@hotmail.com
Dr. Şerife Bektaş
Ankara City Hospital, Intensive
Care Unit, Ankara, Turkey. e-mail: serifegbektas@gmail.com
Dr. Mehmet Eren Yüksel
Ankara Yıldırım Beyazıt
University School of Medicine, Intensive Care Unit, Ankara, Turkey. e-mail:
doctormehmeteren@yahoo.com
Prof. Dr. Seval İzdeş
Ankara Yıldırım Beyazıt
University School of Medicine, Intensive Care Unit, Ankara, Turkey. E-mail:
sevalizdes@yahoo.com
Introduction:The detection of
viral ribonucleic acid using reverse transcription polymerase chain reaction
(RT-PCR) within nasopharyngeal swabs is essential for the diagnosis of
SARS-CoV-2 infection. Myelodysplastic syndrome (MDS) represents a heterogeneous
group of myeloid neoplasms which are characterized by ineffective
hematopoiesis, cytopenia, and risk of progression to acute myeloid leukemia.
Hereby, we present a 62-year-old female patient with both MDS and Covid-19, who
continued to have a positive nasopharyngeal RT-PCR test for 46 days until she
passed away.
Case Report: The patient, who was
diagnosed with MDS in August 2020, was complaining of high fever. She had had
two doses of Sinovac vaccine. Past medical history was remarkable for
chemotherapy which was ended 1 month before. Bone marrow transplantation was
planned within a week. Despite the i.v. ertapenem treatment, high fever
persisted, and neutropenia occurred. White blood cell count (Wbc) was 0.43
x109/L. Blood and urinary cultures revealed extended spectrum beta-lactamase
(ESBL) producing Escherichia coli. In addition, SARS-CoV-2 RT-PCR test on
nasopharyngeal swab was performed, which was revealed to be positive.
Antibiotic treatment was initiated. The patient was admitted to the intensive
care unit. Afterwards, serial nasopharyngeal swabs were collected from the
patient for 46 days until she passed away, and all were positive for Covid-19.
Discussion: In the medical
literature, long-term (longer than 3 weeks) SARS-CoV-2 RT-PCR positivity has
been reported in mild or asymptomatic patients. There are a few number of
publications dealing with MDS and Covid-19 in the English medical literature.
Qing et al. reported MDS in a 30-year-old man with Covid-19, however, RT-PCR
positive period was not mentioned. SARS-CoV-2 clearance period depends on
immunity of the patients and Covid-19 infection may have a prolonged course in patients with
hematological disorders such as MDS.
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Conference: 2. International Cancer Days, Sivas Cumhuriyet University, 16-18 September 2021
https://kansergunleri.cumhuriyet.edu.tr/?page_id=589&lang=tr
