Probable causes and risk factors for positive SARS-CoV-2 test in recovered patients: Evidence from Brunei Darussalam

We report findings of a national study in Brunei Darussalam indicating that one in five recovered patients subsequently test positive again for SARS-CoV-2--this risk is nearly three times higher in older patients (age 53 and above) than younger ones (below age 53). Review of clinical and epidemiological records do not support reinfection or reactivation as likely causes of the re-positive observation. Instead, prolonged but intermittent viral shedding is the most probable explanation. We discuss the implications of these findings for infection control and clinical practice.