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At present, twice successively negative detections of SARS-CoV-2 remain important index for discharged COVID-19 patients, and the median hospital stay is 10 days 6 . Here, we reported an asymptomatic COVID-19 patient with persistent positive detection of SARS-CoV-2 RNA for 3 weeks, and proposed that glucocorticoid therapy might not only cause atypical infections, but also delay the clearance of SARS-CoV-2 RNA.
On January 24, a 48-year-old man with fever for 4 days was admitted to the hospital, and he had a history of short stay in Wuhan. Moreover, he had a 10-year history of asthma, and persistently received the inhaled glucocorticoids (salmeterol/fluticasone) at a dose of 50/250 μg twice daily. On admission, he developed low-grade fever and cough. CT images showed the increase of ground-glass opacity in the bilateral superior lobe. Nasopharyngeal swab sample was collected with the standard process as previously described 7 . RNA was extracted with the protease K-magnetic beads (BioPerfectus Technologies, China). From January 25 to January 28, he received efficient antiviral treatment, including oseltamivir, lopinavir/ritonavir and IFNα-2b. Considering the asthma attack, the patient felt chest tightness to receive the atomization budesonide and terbutaline from January 25. From January 28, he was treated with methylprednisolone to prevent the exacerbation. On January 31, he had the obvious improvement in respiratory symptoms. From February 1, he developed a wheeze and paroxysmal cough, and was administered with budesonide and terbutaline to reduce the airway