American Journal of Epidemiology and Infectious Disease
ISSN (Print): 2333-116X ISSN (Online): 2333-1275 Website: Editor-in-chief: John Opuda-Asibo
Open Access
Journal Browser
American Journal of Epidemiology and Infectious Disease. 2021, 9(1), 11-17
DOI: 10.12691/ajeid-9-1-3
Open AccessArticle

Recurrent Symptomatic SARS-CoV-2 RT PCR Positivity among Healthcare Professionals: A Series of Cases

Kyle Martin S. Alimurung1, Sigrid D. Santos2, Maria Clarina D. Mariano2, Aliza S. Concepcion2 and Janice C. Caoili3,

1Department of Medicine, Makati Medical Center, #2 Amorsolo Street, Legazpi Village, Makati, 1229, Philippines

2Infection Prevention and Control Department, Makati Medical Center, #2 Amorsolo Street, Legazpi Village, Makati, 1229, Philippines

3Section of Infectious Disease, Department of Medicine, Makati Medical Center, #2 Amorsolo Street, Legazpi Village, Makati, 1229, Philippines

Pub. Date: August 06, 2021

Cite this paper:
Kyle Martin S. Alimurung, Sigrid D. Santos, Maria Clarina D. Mariano, Aliza S. Concepcion and Janice C. Caoili. Recurrent Symptomatic SARS-CoV-2 RT PCR Positivity among Healthcare Professionals: A Series of Cases. American Journal of Epidemiology and Infectious Disease. 2021; 9(1):11-17. doi: 10.12691/ajeid-9-1-3


Background: The ongoing COVID-19 pandemic has led to heightened health risk to health professionals from recurrent symptomatic SARS-CoV-2 infections due to continuous exposure in the workplace. Objectives: To highlight the need for universal clinical guidelines to provide clarity on appropriate interpretation and management of symptomatic recurrent positive SARS-CoV-2 reverse-transcription polymerase-chain-reaction (RT PCR) test results among healthcare professionals (HCPs) with a documented history of COVID-19 exposure. Methods: We present five cases of HCPs working at Makati Medical Center in the Philippines who previously recovered from symptomatic COVID-19 infection and presented at least 87 days after recovery with recurrent symptoms consistent with COVID-19 infection along with positive nasopharyngeal and oropharyngeal swab (NPS/OPS) RT PCR on repeat testing, suggesting recurrent infection. Results: Our cases had a disease-free average interval of 99 days (range of 87 to 124 days) between infection episodes. On serologic testing, only one case developed IgM and IgG antibodies after first infection. Four of five cases were deemed sources of infection transmission for new confirmed COVID-19 cases during at least one of their infection episodes. Discussion: Our cases highlight the dilemma of lack of universal clinical guidelines regarding appropriate interpretation of and management of recurrent positive SARS-CoV-2 RT PCR HCPs who are continuously exposed in clinical settings where limited or no access to genotyping and viral culture are available to validate reinfections, whether with prevalent strains and/or variants.

COVID-19 SARS-CoV-2 RT PCR coronavirus recurrent serologic testing healthcare professionals

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020; 395(10223): 497-506.
[2]  Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. New England Journal of Medicine. 2020; 382(13): 1199-207.
[3]  Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. New England Journal of Medicine. 2020; 382(8): 727-33.
[4]  Adhikari SP, Meng S, Wu Y-J, Mao Y-P, Ye R-X, Wang Q-Z, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infectious Diseases of Poverty. 2020; 9(1).
[5]  University JH. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). 2021.
[6]  Duggan NM, Ludy SM, Shannon BC, Reisner AT, Wilcox SR. A case report of possible novel coronavirus 2019 reinfection. The American Journal of Emergency Medicine. 2020.
[7]  Chen D, Xu W, Lei Z, Huang Z, Liu J, Gao Z, et al. Recurrence of positive SARS-CoV-2 RNA in COVID-19: A case report. International Journal of Infectious Diseases. 2020; 93: 297-9.
[8]  Hoang VT, Dao TL, Gautret P. Recurrence of positive SARS-CoV-2 in patients recovered from COVID-19. Journal of Medical Virology. 2020.
[9]  Yongchen Z, Shen H, Wang X, Shi X, Li Y, Yan J, et al. Different longitudinal patterns of nucleic acid and serology testing results based on disease severity of COVID-19 patients. Emerging Microbes & Infections. 2020; 9(1): 833-6.
[10]  Lan L, Xu D, Ye G, Xia C, Wang S, Li Y, et al. Positive RT-PCR Test Results in Patients Recovered From COVID-19. JAMA. 2020; 323(15):1502.
[11]  Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020; 395(10229): 1054-62.
[12]  Xiao AT, Tong YX, Gao C, Zhu L, Zhang YJ, Zhang S. Dynamic profile of RT-PCR findings from 301 COVID-19 patients in Wuhan, China: A descriptive study. Journal of Clinical Virology. 2020; 127: 104346.
[13]  Li N, Wang X, Lv T. Prolonged SARS-CoV-2 RNA shedding: Not a rare phenomenon. Journal of Medical Virology. 2020.
[14]  Kang H, Wang Y, Tong Z, Liu X. Retest positive for SARS-CoV-2 RNA of “recovered” patients with COVID-19: Persistence, sampling issues, or re-infection? Journal of Medical Virology. 2020.
[15]  An J, Liao X, Xiao T, Qian S, Yuan J, Ye H, et al. Clinical characteristics of the recovered COVID-19 patients with re-detectable positive RNA test. 2020.
[16]  Huang J, Zheng L, Li Z, Hao S, Ye F, Chen J, et al. Recurrence of SARS-CoV-2 PCR positivity in COVID-19 patients: a single center experience and potential implications. 2020.
[17]  Gidari A, Nofri M, Saccarelli L, Bastianelli S, Sabbatini S, Bozza S, et al. Is recurrence possible in coronavirus disease 2019 (COVID-19)? Case series and systematic review of literature. European Journal of Clinical Microbiology & Infectious Diseases. 2020.
[18]  European Centre for Disease Prevention and Control. Reinfection with SARS-CoV-2: considerations for public health response. 2020.
[19]  Rhee C, Kanjilal S, Baker M, Klompas M. Duration of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectivity: When Is It Safe to Discontinue Isolation? Clinical Infectious Diseases. 2020.
[20]  Christensen J. British study shows evidence of waning immunity to Covid-19 2020 [updated October 27, 2020. Available from: