tetano
Editor, Senior Moderator
J Med Virol
. 2020 Jun 10.
doi: 10.1002/jmv.26153. Online ahead of print.
Diagnosis of COVID-19 Pneumonia Despite Missing Detection of Viral Nucleic Acid and Initially Inconspicuous Radiologic Findings
Martin Schiller[SUP] 1 [/SUP], Stephan Wydra[SUP] 2 [/SUP], Hans Ulrich Kerl[SUP] 3 [/SUP], Wolfgang Kick[SUP] 1 [/SUP]
Affiliations
Abstract
The diagnosis of coronavirus disease 2019 (COVID-19) is mainly based on a positive SARS-CoV-2 polymerase chain reaction (PCR) result. PCR samples are obtained from upper or lower respiratory tract specimens. However, the sensitivity of PCR is known to have some limitations. We report on a patient who was admitted to our hospital with dyspnea, fever, cough and history of contact to a SARS-CoV-2 infected relative. The initial chest computed tomography (CT) showed only minimal changes and SARS-CoV-2 PCR from a nasopharyngeal swab sample was negative. PCR results obtained from further nasopharyngeal swabs, qualified sputum samples, and from a lower respiratory tract specimen also remained negative. At day 13 after admission, a second chest CT showed radiological findings suspicious for viral pneumonia. Finally, serologic results showed high levels of IgG and IgA antibodies against the S1 domain of the SARS-CoV-2 spike protein and the patient was diagnosed with COVID-19 pneumonia. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; SARS-CoV-2; pneumonia.
. 2020 Jun 10.
doi: 10.1002/jmv.26153. Online ahead of print.
Diagnosis of COVID-19 Pneumonia Despite Missing Detection of Viral Nucleic Acid and Initially Inconspicuous Radiologic Findings
Martin Schiller[SUP] 1 [/SUP], Stephan Wydra[SUP] 2 [/SUP], Hans Ulrich Kerl[SUP] 3 [/SUP], Wolfgang Kick[SUP] 1 [/SUP]
Affiliations
- PMID: 32519760
- DOI: 10.1002/jmv.26153
Abstract
The diagnosis of coronavirus disease 2019 (COVID-19) is mainly based on a positive SARS-CoV-2 polymerase chain reaction (PCR) result. PCR samples are obtained from upper or lower respiratory tract specimens. However, the sensitivity of PCR is known to have some limitations. We report on a patient who was admitted to our hospital with dyspnea, fever, cough and history of contact to a SARS-CoV-2 infected relative. The initial chest computed tomography (CT) showed only minimal changes and SARS-CoV-2 PCR from a nasopharyngeal swab sample was negative. PCR results obtained from further nasopharyngeal swabs, qualified sputum samples, and from a lower respiratory tract specimen also remained negative. At day 13 after admission, a second chest CT showed radiological findings suspicious for viral pneumonia. Finally, serologic results showed high levels of IgG and IgA antibodies against the S1 domain of the SARS-CoV-2 spike protein and the patient was diagnosed with COVID-19 pneumonia. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; SARS-CoV-2; pneumonia.