ProMED Digest, Vol 102, Issue 33. December 10, 2020. Patient is a 39-year-old white male, A-negative blood type, seen in July 2020 for anxiety, states otherwise healthy, had complained of a “SARS-like” illness in February 2020, with symptoms of mild fever, body aches and impaired smell. Patient recovered after 2 weeks of just self-supportive care. [When seen in July 2020] was noted to have a normal Chem 21 panel, CBC, and a positive SARS-CoV-2 IgG on serum lab [serum sent to 2 different commercial labs: 1 was positive for SAR-CoV-2 IgG, the other was negative — verbal report speaking to Dr. Hall].
During a trip to Mexico to attend “Art With Me,” an art and music festival that ran 11-15 Nov 2020 in Tulum, Mexico, new health events presented. At that time, he complained of feeling unwell and having issues with slight fever on 17 Nov 2020. On morning of 18 Nov 2020, on presumption of possible flu-like respiratory illness or COVID-19, he was advised to see physician as he had complaints of mild fever-like chills and self-assessed oxygen levels of 94%. He was immediately seen by a hotel doctor, was given “shot” and oral azithromycin, monitored, told that because he had previously tested positive for SARS-CoV-2 IgG that COVID-19 was unlikely, and was not PCR tested in Mexico.
On 19 Nov 2020, oxygen levels of 92% were observed and a temperature of 99.5 deg F [37.5 deg C] noted. Fearful, he traveled back to Miami without PCR screen as per hotel doctor’s advice. He was screened in Miami and found to be PCR positive for SARS-CoV-2. We presume he had lost his previous antibody protection between July and November 2020. The event the patient attended in Tulum was described a super-spreader event. Please be advised on the dynamics of the 2nd infection and that his new symptoms were worse than his 1st episode.
Michael Hall, MD