key: cord-252423-ojmt4k2w
authors: Qu, Bing; Yang, Jing
title: Monologue of a physician who tested persistently positive for COVID-19
date: 2020-05-11
journal: Clin Infect Dis
DOI: 10.1093/cid/ciaa551
sha: 
doc_id: 252423
cord_uid: ojmt4k2w

nan

M a n u s c r i p t 2 Dear Editor:

Life is doomed to be dramatic.

As human beings, we tend to think that bad things, such as earthquake, fires, car accident, and severe illness, never occur to us. We believe that these things never happen, even though we have seen or heard about such tragedies that others experienced.

When a major medical event hits, the general public is prone to judge it based on their own experience without sufficient specific medical knowledge. Healthcare professionals are sometimes no exception, particularly when a new/unknown disease emerges. The COVID-19, as other new infectious diseases, has presented us unprecedented challenges and put us into huge dilemma.

As a physician on clinical frontline, I had been treating patients actively and wishing them an early recovery, but never expecting that I would be infected. However, I suddenly turned into a patient, an ill person in need of intensive care.

As in the early stage we knew little about COVID-19 and the possibility that someone with COVID-19 can transmit the virus even if they are not showing symptoms, many healthcare professionals were infected. The situation became even worse later due to the shortage of medical supplies, inadequate protective equipment, and accumulated fatigue of medical staff as a result of high intensity work. According to a Press Conference of the WHO-China Joint Mission on COVID-19 on February 24, 3387 medical staff have been reported to be infected, among which over 90% were from Hubei province. 1 Similar to other COVID-19 patients, I had dry cough, fever, body aches, and fatigue during the first week. My chest CT examination showed features of ground-glass opacities, and, of course, my RT-PCR test was positive. It has been reported that clinical deterioration/improvement occurs during the second week of illness. 2 On the 10th day after the onset, I developed chest tightness and palpitations, which became worse after activities. The CT re-examination showed increased and enlarged lesions in both lungs. With the additional administration of small doses of glucocorticoids, the clinical symptoms completely disappeared in the third week.

Unexpectedly, the CT scan in the fourth week revealed new lesions in the right lung which showed lesions completely absorbed the week before. Moreover, my RT-PCT retests (eight times) were all positive after hospital admission. All of these indicated that the disease remained M a n u s c r i p t 3 uncontrolled. As a potential "persistently positive" patient, I was not alone. The Corriere della Sera, a daily newspaper in Milan, reported that a 23-year-old model had tested positive for novel coronavirus six times during the 57 days after her diagnosis [reference]. This new group of patients have brought new challenge to COVID-19 treatment. However, the cause of "persistent positiveness" remains unknown, and no treatment has so far been proven to efficiently help patient turn positive to negative.

As time went by, my condition neither worsened nor improved. The courage to win the battle was gone. Unstable mood swing started, accompanied by endless imagination of gain and loss. Was it due to that COVID-19 is severer than other infectious diseases such as seasonal flu? Or was it due to a lack of proper immune responses? Is it possible that I would become a long-term carrier of this new coronavirus？Would I be discriminated against? There is no existing/specific medication for the disease. My heart rate was high (the highest was 130). Given a high Angiotensin-converting enzyme 2 (ACE2) level in heart, would the virus attack the heart and cause viral myocarditis? Would it lead to cardiopulmonary sequelae? The China's Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia has been renewed six times, but various treatment options still exist and agreement has yet to be reached.

Singing is my favorite way to relieve pressure. When I sang my favorite folk"chengdu" in the hospital room, my daughter played piano accompaniment for me at home through online video, which made us immersed into her piano sound. It is also as if we casually went from street to street in search of local various food with my daughter holding my right cuff while I putting my left hand in my trouser pocket.

"Daddy, when are you going home?" My daughter repeated in every video call. "A few more days." "A few more days? How many more days exactly?!" She pouted, and I knew she was upset.

My friends sent me photos of food, boasting as if they were chefs and gourmets. I knew they just tempted me with food, and encouraged me to carry on.

Relatives, colleagues, and friends sent me wishes to keep me warm. Doctors and nurses encouraged me to stay strong. It seemed that my life was back to normal and full of trivial things: chatting with family and neighbors, and strolling on the street or in the campus. I stopped distorted thinking but gradually calmed down.

Finally, after 53 days of hospitalization with treatment of integrated Chinese and western medicine, I was declared cured and discharged! I wanted to thank every person who offered me support and helpyou are the torch carriers, lighting my way home. M a n u s c r i p t 4 The epidemic in China is at present under control and being improved, but COVID-19 has become a pandemic and spread rapidly across the whole world. Although the disease was first reported in China, the source of the virus has not been confirmed. Many issues regarding prevention, control and treatment of the disease need to be addressed by medical scientists and sociologists all together in the world.

As a doctor infected with this highly infectious disease, I sincerely exhort that all of us stay in awe of the virus but do not despise or panic. We should not only maintain proactive health and hygiene regiments, but also cooperate and study actively to fully understand and defeat COVID-19.

M a n u s c r i p t 5

Exploring the reasons for healthcare workers infected with novel coronavirus disease 2019 (COVID-19) in China

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

We thank Dr. Ruoqing Chen for her help with language editing. 

A c c e p t e d M a n u s c r i p t 6