Recurrent SARS-CoV-2 infection resulting in acute respiratory distress syndrome and development of pulmonary hypertension: A case report

The COVID-19 pandemic has affected millions of individuals worldwide. In the United States, the rapid transmission of cases has created challenges for healthcare systems across the country. We report a case of a patient who fully recovered from COVID-19 with intermittent negative RT-PCR testing and a symptom free interval who went on to develop a second infection. The patient's second infection resulted in a more severe clinical course. The patient developed Acute Respiratory Distress Syndrome resulting in intubation twice and an extensive stay in the intensive care unit. Six weeks post-discharge, the patient was evaluated for continued dyspnea, hypoxia, and continued oxygen dependence. The patient subsequently underwent right heart catherization for further evaluation and was found to have newly developed pulmonary hypertension. Given the possibility of second wave infections this fall and winter, this case highlights the concern that re-infections with COVID-19 could cause substantially worse clinical outcomes and long-term complications. In terms of ongoing vaccine development, the short lived immune response in this case calls into question the ability of a future vaccine to provide long term lasting immunity against COVID-19.