But that's basically what Reelya said. His IgM was still positive, so he never seroconverted in the first place. He tested negative foe pcr for four days, then was positive again. It's the same as the other cases: not a reinfection, but prolonged viral DNA shedding.
The authors say it themselves in the discussion and for what I've seen this is the most common interpretation of these cases.
Given the possibility of recurrently positive SARS-CoV-2 RNA, especially in immunocompromised patients, and the uncertainty of infectivity of recurrently positive patients, the discharged patients should continue to be quarantined for at least 14 days and monitored for SARS-CoV-2 RNA repeatedly, and be wary of becoming a virus carrier and thereby spreading the virus to others.
So the issue is recurrent positivity, more than recurrent infection.
They also talk a lot about the patient being immunocompromised, and this affecting prolonged viral positivity.... while that IS something you do see with immunocompromised patients and other viruses (eg the flu), I'm not really sure why they say the guy is immunocompromised as they dont mention any of the usual suspects in his clinical background. I assume they might mean the lymphocyte counts they did during admission? But it's kind of common to see drops during infections, especially severe ones, and was widely reported as a common finding in covid19🤔. I'm pretty sure some of the early score tables for ER used it as a potential sign.
Anyway:
These other guys posted a report on pcr positivity a while ago
https://t.co/DA7nyEkSA9?amp=1It fluctuates up and down. Close to the threshold it creates problems... its an open question whether these guys are infectious too but I dont think anyone wants to risk it.