TY - JOUR
T1 - Recurrence, Reactivation, or Inflammatory Rebound of SARS-CoV-2 Infection With Acute Vestibular Symptoms: A Case Report and Revision of Literature
AU - Zaffina, Salvatore
AU - Lanteri, Paola
AU - Gilardi, Francesco
AU - Garbarino, Sergio
AU - Santoro, Annapaola
AU - Vinci, Maria Rosaria
AU - Carsetti, Rita
AU - Scorpecci, Alessandro
AU - Raponi, Massimiliano
AU - Magnavita, Nicola
AU - Camisa, Vincenzo
PY - 2021
Y1 - 2021
N2 - A case of recurrent coronavirus disease 2019 (COVID-19) with neurovestibular symptoms was reported. In March 2020, a physician working in an Italian pediatric hospital had flu-like symptoms with anosmia and dysgeusia, and following a reverse transcription PCR (RT/PCR) test with a nasopharyngeal swab tested positive for SARS-CoV-2. After home quarantine, 21 days from the beginning of the symptoms, the patient tested negative in two subsequent swabs and was declared healed and readmitted to work. Serological testing showed a low level of immunoglobulin G (IgG) antibody title and absence of immunoglobulin M (IgM). However, 2 weeks later, before resuming work, the patient complained of acute vestibular syndrome, and the RT/PCR test with mucosal swab turned positive. On the basis of the literature examined and reviewed for recurrence cases and vestibular symptoms during COVID-19, to our knowledge this case is the first case of recurrence with vestibular impairment as a neurological symptom, and we defined it as probably a viral reactivation. The PCR retest positivity cannot differentiate re-infectivity, relapse, and dead-viral RNA detection. Serological antibody testing and viral genome sequencing could be always performed in recurrence cases.
AB - A case of recurrent coronavirus disease 2019 (COVID-19) with neurovestibular symptoms was reported. In March 2020, a physician working in an Italian pediatric hospital had flu-like symptoms with anosmia and dysgeusia, and following a reverse transcription PCR (RT/PCR) test with a nasopharyngeal swab tested positive for SARS-CoV-2. After home quarantine, 21 days from the beginning of the symptoms, the patient tested negative in two subsequent swabs and was declared healed and readmitted to work. Serological testing showed a low level of immunoglobulin G (IgG) antibody title and absence of immunoglobulin M (IgM). However, 2 weeks later, before resuming work, the patient complained of acute vestibular syndrome, and the RT/PCR test with mucosal swab turned positive. On the basis of the literature examined and reviewed for recurrence cases and vestibular symptoms during COVID-19, to our knowledge this case is the first case of recurrence with vestibular impairment as a neurological symptom, and we defined it as probably a viral reactivation. The PCR retest positivity cannot differentiate re-infectivity, relapse, and dead-viral RNA detection. Serological antibody testing and viral genome sequencing could be always performed in recurrence cases.
KW - case report
KW - healthcare workers
KW - neuroCOVID
KW - neurologic symptoms
KW - occupational medicine
KW - recurrence
KW - vestibular syndrome
KW - case report
KW - healthcare workers
KW - neuroCOVID
KW - neurologic symptoms
KW - occupational medicine
KW - recurrence
KW - vestibular syndrome
UR - http://hdl.handle.net/10807/188175
U2 - 10.3389/fnhum.2021.666468
DO - 10.3389/fnhum.2021.666468
M3 - Article
SN - 1662-5161
VL - 15
SP - 666468-N/A
JO - Frontiers in Human Neuroscience
JF - Frontiers in Human Neuroscience
ER -