The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly infectious RNA coronavirus responsible for the pandemic of the coronavirus disease 2019 (COVID-19). Recent advances in virology, epidemiology, diagnosis, and clinical management of COVID-19 have contributed to the control and prevention of this disease, but re-positivity of SARS-CoV-2 in recovered COVID-19 patients has brought a new challenge for this worldwide anti-viral battle. Reverse transcription polymerase chain reaction (RT-PCR) tests of the SARS-CoV-2 pathogen is widely used in clinical diagnosis, but a positive RT-PCR result may be multifactorial, including false positive, SARS-CoV-2 RNA fragment shedding, reinfection of SARS-CoV-2, or re-activation of COVID-19. Re-infection of SARS-CoV-2 or re-activation of COVID-19 is an indicator of live viral carriers and isolation/treatment is needed, but SARS-CoV-2 RNA fragment shedding is not. SARS-CoV-2 RNA is recently reported to integrate into the host genome, but the far-reaching outcome is currently unclear. Therefore, it is critical for appropriate manipulation and prevention of COVID-19 to distinguish these causal factors of SARS-CoV-2 re-positivity. In this review article, we updated the current knowledge of SARS-CoV-2 re-positivity in discharged COVID-19 patients with a focus on re-infection and re-activation. We proposed a hypothetical flowchart for handling of the SARS-CoV-2 re-positive cases.

中文翻译：

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出院的 COVID-19 患者中 SARS-CoV-2 病毒 RNA 再阳性的差异。

新型严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 是一种高度传染性的 RNA 冠状病毒，导致 2019 年冠状病毒病 (COVID-19) 的大流行。COVID-19 病毒学、流行病学、诊断和临床管理的最新进展有助于控制和预防该疾病，但康复的 COVID-19 患者中 SARS-CoV-2 的重新阳性为此带来了新的挑战全球抗疫大战。SARS-CoV-2病原体的逆转录聚合酶链反应（RT-PCR）测试广泛用于临床诊断，但RT-PCR阳性结果可能是多因素的，包括假阳性、SARS-CoV-2 RNA片段脱落、 SARS-CoV-2 的再感染，或 COVID-19 的再激活。SARS-CoV-2 的重新感染或 COVID-19 的重新激活是活病毒携带者的一个指标，需要进行隔离/治疗，但 SARS-CoV-2 RNA 片段脱落不是。最近有报道称 SARS-CoV-2 RNA 整合到宿主基因组中，但目前尚不清楚影响深远的结果。因此，区分这些导致 SARS-CoV-2 重新阳性的致病因素对于适当操作和预防 COVID-19 至关重要。在这篇综述文章中，我们更新了出院 COVID-19 患者中 SARS-CoV-2 再阳性的当前知识，重点是再感染和再激活。我们提出了处理 SARS-CoV-2 再阳性病例的假设流程图。但影响深远的结果目前尚不清楚。因此，区分这些导致 SARS-CoV-2 重新阳性的致病因素对于适当操作和预防 COVID-19 至关重要。在这篇综述文章中，我们更新了出院 COVID-19 患者中 SARS-CoV-2 再阳性的当前知识，重点是再感染和再激活。我们提出了处理 SARS-CoV-2 再阳性病例的假设流程图。但影响深远的结果目前尚不清楚。因此，区分这些导致 SARS-CoV-2 重新阳性的致病因素对于适当操作和预防 COVID-19 至关重要。在这篇综述文章中，我们更新了出院 COVID-19 患者中 SARS-CoV-2 再阳性的当前知识，重点是再感染和再激活。我们提出了处理 SARS-CoV-2 再阳性病例的假设流程图。