A Case of COVID-19 Pneumonia Complicating Rhinitis/Sinusitis that Required 41 Days from Onset to Two Consecutive Negative Results of the SARS-CoV-2 PCR Test

Abstract

We report the case of a patient with pneumonia caused by the new coronavirus (COVID-19 pneumonia), who contracted the novel coronavirus (SARS-CoV-2) infection on a large cruise ship, and was hospitalized due to fever and cough The fever resolved immediately after admission, however, a mild cough persisted Chest CT showed multiple ground-glass opacities in the upper and lower lobes of both lungs However, we judged that the patient was at a low risk of exacerbation of the disease as he was young, and did not administer any antiviral drugs Since the subjective symptoms improved, we repeated the SARS-CoV-2 PCR test on day 9 after the onset of the illness, but the result was still positive As the patient was observed to have sinus stenosis in the left nasal cavity at the time of collection of the nasopharyngeal swab for testing, sinus CT was performed The findings were suggestive of inflammation of the left nasal mucosa, ethmoid sinusitis, and maxillary sinusitis It took a long 41 days before we could finally confirm two consecutive negative results of the nasopharyngeal swab PCR test for the novel virus It has not yet been clarified whether the SARS-CoV2-19 virus can cause rhinitis and/or sinusitis, but from our experience of this case, we believe that SARS-CoV2-19 can colonize already infected nasal mucosa and sinuses for a prolonged period of time It is necessary to pay attention to this aspect, as it may prolong the disease duration and/or increase the risk of relapse