loading page

Re-positive nucleic acid test in COVID-19 Patients: A systematic review
  • +2
  • Ali Nowroozi,
  • Amirali Karimi,
  • Sanam Alilou,
  • Nastaran Khalili,
  • Nima Rezaei
Ali Nowroozi
Tehran University of Medical Sciences School of Medicine
Author Profile
Amirali Karimi
Tehran University of Medical Sciences School of Medicine
Author Profile
Sanam Alilou
Tehran University of Medical Sciences School of Medicine
Author Profile
Nastaran Khalili
Tehran University of Medical Sciences School of Medicine
Author Profile
Nima Rezaei
Tehran University of Medical Sciences

Corresponding Author:[email protected]

Author Profile

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test could be positive for a second time in some cases, after recovery from their first coronavirus disease 2019 (COVID-19) episode. However, causes of this re-positive test has not been fully understood. In this paper, the original studies with re-positive COVID-19 patients in their study population were discussed. Methods: Scopus, PubMed, Embase, and Cochrane databases were searched and the retrieved records underwent title/abstract and full-text screenings. Three independent researchers extracted the data of the studies. Results: The systematic search yielded 16 case-control, cohort, and cross-sectional studies. Data of 10,475 patients were included; 489 (4.67%) of them classified as re-positive. The female percentage and mean age for re-positive and non-re-positive groups were 56.82% and 50.0 ± 18.0, and 55.91% and 46.6 ± 17.1, respectively. The rate of symptom presentation upon second positive test turned out to be 20.0%, with the most common symptoms being cough (68.2%), fever (31.8%), and fatigue (22.7%). Hypertension (15.9%) accounted for the most common underlying disease in the re-positive group. In 33/46 (71.7%) of the re-positive patients, computed tomography (CT) abnormalities were resolved to some extent. Conclusion: A re-positive SARS-CoV-2 test is possible within a few weeks after recovery, although it does not necessarily indicate a re-infection. Other reasons could lead to a re-positive test such as reactivation of the virus that persisted in the body from the previous COVID-19 episode and testing errors. Clinical features such as symptoms and imaging could assist in identifying re-infections.