World J Clin Cases 8(12): 2655-2661

PMC: PMC7322412

PMID: 32607346

Low-grade fever during COVID-19 convalescence: A report of 3 cases

Shu-Fan Zhuang, Department of Gastroenterology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China;

Contributor Information.

Author contributions: Zhuang SF and Hu J reviewed the literature and drafted the manuscript; Qiao N drafted all tables and figures; Hu J, Lan ZH, and Lai JY treated these patients and participated in collecting data; Wu JG guided treatment; Wu XY performed the radiographic analyses; All authors read and approved the final manuscript.

Supported by Emergency Special Project on Prevention and Treatment of COVID-19 with Traditional Chinese Medicine, No. 2020YBBGWL007.

Corresponding author: Jia Hu, PhD, Attending Doctor, Academic Research, Department of Gastroenterology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, 445 Bayi Avenue, Donghu District, Nanchang 330006, Jiangxi Province, China. nc.ude.ucn.liame@300612925653

Supported by Emergency Special Project on Prevention and Treatment of COVID-19 with Traditional Chinese Medicine, No. 2020YBBGWL007.

Received 2020 Mar 21; Revised 2020 May 5; Accepted 2020 May 21.

This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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.

Abstract

BACKGROUND

Low-grade fever during convalescence is an atypical symptom of coronavirus disease 2019 (COVID-19). Reports of such cases are rare, and the mechanism and outcome of low-grade fever during COVID-19 convalescence are not completely clear. We report 3 cases with low-grade fever during COVID-19 convalescence and highlight the main clinical, radiographic, and laboratory characteristics, thereby increasing the level of expertise in the clinical management of COVID-19 during convalescence and facilitating individualized decision-making.

CASE SUMMARY

We describe 3 patients with COVID-19, two females aged 62 and 66 years and a male 55 years, who had low-grade fever during COVID-19 convalescence. All 3 patients had no other discomfort or comorbidities during low-grade process. Lesions on computed tomography in all 3 patients had resolved during this period. Two patients tested negative on two consecutive severe acute respiratory syndrome coronavirus 2 tests with an interval of at least 24 h between tests. Body temperature in all 3 patients returned to normal after several days without treatment, and fever recurrence was not observed.

CONCLUSION

Enhancing the knowledge of low-grade fever during COVID-19 convalescence may increase the expertise in the delivery of optimal healthcare services.

Keywords: COVID-19, Convalescence, Low-grade fever, Clinical characteristics, SARS-CoV-2, Case report

Core tip: Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide, and our knowledge of this infection is still insufficient in many respects. We present 3 cases with low-grade fever during COVID-19 convalescence. These cases highlight the main clinical, radiographic, and laboratory characteristics of COVID-19 and help provide guidance for frontline medical staff in terms of clinical management and individualized decision-making during convalescence.

++: Severe; +: Mild or moderate. CRP: C-reactive protein; Hb: Hemoglobin; NA: Not available; N: Negative; NEUT: Neutrophils; P: Positive; PCT: Procalcitonin; PLT: Platelet; SAA: Serum amyloid A; RBC: Red blood cell; WBC: White blood cell.

Footnotes

Manuscript source: Unsolicited manuscript

Specialty type: Medicine, research and experimental

Country/Territory of origin: China

Peer-review report’s scientific quality classification

Grade A (Excellent): 0

Grade B (Very good): 0

Grade C (Good): C

Grade D (Fair): D

Grade E (Poor): 0

Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Peer-review started: March 21, 2020

First decision: April 24, 2020

Article in press: May 21, 2020

P-Reviewer: Georgiev T, Khan S S-Editor: Wang JL L-Editor: Filipodia E-Editor: Zhang YL

Contributor Information

Shu-Fan Zhuang, Department of Gastroenterology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China.

Jia Hu, Department of Gastroenterology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China. nc.ude.ucn.liame@300612925653.

Nan Qiao, Department of Student Affairs, Jiangxi Institute of Economic Administrators, Nanchang 330088, Jiangxi Province, China.

Zhi-Hui Lan, Department of Respiration, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China.

Jun-Yu Lai, Department of Cardiology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China.

Jian-Guang Wu, Department of Cardiology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China.

Xiao-Yong Wu, Department of Radiology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China.

References

1. Jiang F, Deng L, Zhang L, Cai Y, Cheung CW, Xia ZReview of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19) J Gen Intern Med. 2020;35:1545–1549.[Google Scholar]
2. Velavan TP, Meyer CGThe COVID-19 epidemic. Trop Med Int Health. 2020;25:278–280.[Google Scholar]
3. Phan TGenetic diversity and evolution of SARS-CoV-2. Infect Genet Evol. 2020;81:104260.[Google Scholar]
4. He F, Deng Y, Li WCoronavirus disease 2019: What we know? J Med Virol. 2020[Google Scholar]
5. Ling Y, Xu SB, Lin YX, Tian D, Zhu ZQ, Dai FH, Wu F, Song ZG, Huang W, Chen J, Hu BJ, Wang S, Mao EQ, Zhu L, Zhang WH, Lu HZPersistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients. Chin Med J (Engl) 2020;133:1039–1043.[Google Scholar]
6. Hastreiter AA, Makiyama EN, Borelli P, Fock RAImpairment of G-CSF receptor on granulocytic progenitor cells causes neutropenia in protein malnutrition. Nutrition. 2020;69:110540.[PubMed][Google Scholar]
7. Wen J, Yang T, Wang J, Ma X, Tong Y, Zhao YKanglaite Injection Combined with Chemotherapy versus Chemotherapy Alone for the Improvement of Clinical Efficacy and Immune Function in Patients with Advanced Non-Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2020;2020:8586596.[Google Scholar]
8. Li YX, Wu W, Yang T, Zhou W, Fu YM, Feng QM, Ye JM[Characteristics of peripheral blood leukocyte differential counts in patients with COVID-19] Zhonghua Nei Ke Za Zhi. 2020;59:E003.[PubMed][Google Scholar]
9. Chen D, Xu W, Lei Z, Huang Z, Liu J, Gao Z, Peng LRecurrence of positive SARS-CoV-2 RNA in COVID-19: A case report. Int J Infect Dis. 2020;93:297–299.[Google Scholar]
10. Zhou S, Wang Y, Zhu T, Xia LCT Features of Coronavirus Disease 2019 (COVID-19) Pneumonia in 62 Patients in Wuhan, China. AJR Am J Roentgenol. 2020:1–8.[PubMed][Google Scholar]
11. Pan F, Ye T, Sun P, Gui S, Liang B, Li L, Zheng D, Wang J, Hesketh RL, Yang L, Zheng CTime Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19) Radiology. 2020;295:715–721.[Google Scholar]
12. Ismail SNFB, Baharum SN, Fazry S, Low CFComparative genome analysis reveals a distinct influence of nucleotide composition on virus-host species-specific interaction of prawn-infecting nodavirus. J Fish Dis. 2019;42:1761–1772.[PubMed][Google Scholar]
13. Xu Y, Zhang B, Wang L, Jing T, Chen J, Xu X, Zhang W, Zhang Y, Han JUnusual features and molecular pathways of Staphylococcus aureus L-form bacteria. Microb Pathog. 2020;140:103970.[PubMed][Google Scholar]
14. Saira K, Lin X, DePasse JV, Halpin R, Twaddle A, Stockwell T, Angus B, Cozzi-Lepri A, Delfino M, Dugan V, Dwyer DE, Freiberg M, Horban A, Losso M, Lynfield R, Wentworth DN, Holmes EC, Davey R, Wentworth DE, Ghedin E INSIGHT FLU002 Study Group; INSIGHT FLU003 Study GroupSequence analysis of in vivo defective interfering-like RNA of influenza A H1N1 pandemic virus. J Virol. 2013;87:8064–8074.[Google Scholar]
15. Boergeling Y, Rozhdestvensky TS, Schmolke M, Resa-Infante P, Robeck T, Randau G, Wolff T, Gabriel G, Brosius J, Ludwig SEvidence for a Novel Mechanism of Influenza Virus-Induced Type I Interferon Expression by a Defective RNA-Encoded Protein. PLoS Pathog. 2015;11:e1004924.[Google Scholar]
16. Li Z, Yi Y, Luo X, Xiong N, Liu Y, Li S, Sun R, Wang Y, Hu B, Chen W, Zhang Y, Wang J, Huang B, Lin Y, Yang J, Cai W, Wang X, Cheng J, Chen Z, Sun K, Pan W, Zhan Z, Chen L, Ye FDevelopment and clinical application of a rapid IgM-IgG combined antibody test for SARS-CoV-2 infection diagnosis. J Med Virol. 2020[Google Scholar]
17. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao BClinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.[Google Scholar]