Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2021; 9(21): 5955-5962
Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5955
COVID-19 patient with an incubation period of 27 d: A case report
Xue Du, Yang Gao, Kai Kang, Yang Chong, Mei-Ling Zhang, Wei Yang, Chang-Song Wang, Xiang-Lin Meng, Dong-Sheng Fei, Qing-Qing Dai, Ming-Yan Zhao
Xue Du, Kai Kang, Yang Chong, Mei-Ling Zhang, Wei Yang, Xiang-Lin Meng, Dong-Sheng Fei, Ming-Yan Zhao, Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Yang Gao, Department of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical University, Harbin 150028, Heilongjiang Province, China
Yang Gao, Chang-Song Wang, Institute of Critical Care Medicine, The Sino Russian Medical Research Center of Harbin Medical University, Harbin 150081, Heilongjiang Province, China
Chang-Song Wang, Department of Critical Care Medicine, The Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
Qing-Qing Dai, Department of Critical Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China
Author contributions: Du X, Gao Y, and Zhao MY conceived the study design, carried out the study and drafted the manuscript; Kang K, Chong Y, Zhang ML, Yang W, Wang CS, Meng XL, Fei DS and Dai QQ were involved in design and execution of the study; all authors read and approved the final manuscript. Du X and Gao Y contributed equally to this work.
Supported by National Natural Science Foundation of China, No. 81772045; and Scientific Research Project of Heilongjiang Health and Family Planning Commission, No. 2018086.
Informed consent statement: The study participant provided written informed consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) statement, and the manuscript was prepared and revised according to the CARE Checklist (2016) statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming-Yan Zhao, PhD, Chief Physician, Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 Youzheng Street, Harbin 150001, Heilongjiang Province, China. mingyan0927@yeah.net
Received: October 29, 2020
Peer-review started: October 29, 2020
First decision: February 12, 2021
Revised: February 16, 2021
Accepted: May 15, 2021
Article in press: May 15, 2021
Published online: July 26, 2021
Processing time: 262 Days and 19.4 Hours
Abstract
BACKGROUND

As a highly contagious disease, coronavirus disease 2019 (COVID-19) is wreaking havoc around the world due to continuous spread among close contacts mainly via droplets, aerosols, contaminated hands or surfaces. Therefore, centralized isolation of close contacts and suspected patients is an important measure to prevent the transmission of COVID-19. At present, the quarantine duration in most countries is 14 d due to the fact that the incubation period of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is usually identified as 1-14 d with median estimate of 4-7.5 d. Since COVID-19 patients in the incubation period are also contagious, cases with an incubation period of more than 14 d need to be evaluated.

CASE SUMMARY

A 70-year-old male patient was admitted to the Department of Respiratory Medicine of The First Affiliated Hospital of Harbin Medical University on April 5 due to a cough with sputum and shortness of breath. On April 10, the patient was transferred to the Fever Clinic for further treatment due to close contact to one confirmed COVID-19 patient in the same room. During the period from April 10 to May 6, nucleic acid and antibodies to SARS-CoV-2 were tested 7 and 4 times, respectively, all of which were negative. On May 7, the patient developed fever with a maximum temperature of 39℃, and his respiratory difficulties had deteriorated. The results of nucleic acid and antibody detection of SARS-CoV-2 were positive. On May 8, the nucleic acid and antibody detection of SARS-CoV-2 by Heilongjiang Provincial Center for Disease Control were also positive, and the patient was diagnosed with COVID-19 and reported to the Chinese Center for Disease Control and Prevention.

CONCLUSION

This case highlights the importance of the SARS-CoV-2 incubation period. Further epidemiological investigations and clinical observations are urgently needed to identify the optimal incubation period of SARS-CoV-2 and formulate rational and evidence-based quarantine policies for COVID-19 accordingly.

Keywords: COVID-19; Incubation period; Quarantine duration; SARS-CoV-2; Case report

Core Tip: As the quarantine duration of coronavirus disease 2019 (COVID-19) in most countries is currently 14 d, cases with an incubation period of more than 14 d in the clinic may trigger rapid spread of the epidemic, which requires us to be highly vigilant. We present a COVID-19 patient with an incubation period of 27 d confirmed in the Fever Clinic of The First Affiliated Hospital of Harbin Medical University. Further epidemiological investigations and clinical observations are urgently needed to identify the optimal incubation period of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) and formulate rational and evidence-based quarantine policies for COVID-19 accordingly.