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1.
J Infect Chemother ; 2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1527743

ABSTRACT

The quantitative antigen test based on the chemiluminescent enzyme immunoassay for SARS-CoV-2 has been used in international airports for quarantine in Japan. While cases of false-positive rapid antigen tests for SARS-CoV-2 were reported, false-positive cases of the quantitative antigen test with clinical information are rare. Here, we report a case of acute respiratory infection whose quantitative antigen test for SARS-CoV-2 was suspected to be false positive. A 9-month-old boy who presented with fever and rhinorrhea was admitted to our hospital under the Quarantine Act. He was diagnosed with COVID-19 based on the quantitative antigen test for SARS-CoV-2 performed at the quarantine station. None of the accompanying family members were positive for COVID-19. Nucleic acid amplification tests (NAAT) for SARS-CoV-2 were all negative, and multiplex polymerase chain reaction detected human rhinovirus or enterovirus infection. This case suggests that the results of the quantitative antigen test should be interpreted together with clinical information, and NAAT should be performed when false-positive results are suspected to avoid unnecessary isolation.

2.
Glob Health Med ; 3(3): 180-183, 2021 Jun 30.
Article in English | MEDLINE | ID: covidwho-1262764

ABSTRACT

The Japanese Government has implemented quarantine measures in response to the COVID-19 pandemic. Individuals testing positive at the airport's quarantine office were lodged either in a designated hotel or hospital under the Quarantine Act. The aim of this study is to describe the management of patients with COVID-19 admitted under the Quarantine Act and to evaluate its impact on medical resources. Data were retrospectively collected, including demographics, comorbidities, status at admission, clinical condition, treatment, outcomes, status at discharge, duration of hospitalization, and the cost of hospitalization for all patients hospitalized with COVID-19 at this facility under the Quarantine Act between January 2020 and April 2021. A total of 48 patients (39 males, 9 females; median age: 38.5 years) with COVID-19, half (52.1%) of which were Japanese, were hospitalized under the Quarantine Act. The majority (87.5%) of the patients lived or planned to stay outside of Chiba Prefecture. The most frequent time of admission was 9 PM-1 AM. Hypoxia on admission was observed in 10 (20.8%) patients and oxygen therapy was provided to 8 (16.7%). One patient died due to respiratory failure. The median duration of hospitalization was 11 days. The total cost of hospitalization was 82,705,289 yen (approximately $760,000), which was covered by public funds. Patients hospitalized with COVID-19 under the Quarantine Act were younger and less severely ill than inpatients with COVID-19 from among the general population in Japan (according to a COVID-19 registry), but consumed a significant amount of medical resources at this hospital. An efficient system to manage patients with COVID-19 in designated hotels should be created and indications for hospitalization should be determined.

3.
Intern Med ; 59(22): 2951-2953, 2020.
Article in English | MEDLINE | ID: covidwho-941724

ABSTRACT

We herein report the first case of a fever induced by favipiravir, a potential coronavirus disease 2019 therapeutic drug. An 82-year-old man diagnosed with bilateral pneumonia was transferred to our hospital following a positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test. He was treated with compassionate use of favipiravir. Both his oxygen demand and fever gradually improved after admission; however, his fever relapsed, and the C-reactive protein (CRP) levels increased on day 7. We diagnosed his fever as being favipiravir-induced. The fever resolved a few days after favipiravir discontinuation, demonstrating the accuracy of the diagnosis. This case revealed that favipiravir can induce a fever.


Subject(s)
Amides/adverse effects , Betacoronavirus , Coronavirus Infections/drug therapy , Fever/chemically induced , Pneumonia, Viral/drug therapy , Pyrazines/adverse effects , Aged, 80 and over , Amides/therapeutic use , Antiviral Agents/adverse effects , Antiviral Agents/therapeutic use , COVID-19 , Coronavirus Infections/epidemiology , Humans , Male , Pandemics , Pneumonia, Viral/epidemiology , Pyrazines/therapeutic use , SARS-CoV-2
4.
Antimicrob Agents Chemother ; 64(12)2020 11 17.
Article in English | MEDLINE | ID: covidwho-939841

ABSTRACT

Favipiravir is an oral broad-spectrum inhibitor of viral RNA-dependent RNA polymerase that is approved for treatment of influenza in Japan. We conducted a prospective, randomized, open-label, multicenter trial of favipiravir for the treatment of COVID-19 at 25 hospitals across Japan. Eligible patients were adolescents and adults admitted with COVID-19 who were asymptomatic or mildly ill and had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Patients were randomly assigned at a 1:1 ratio to early or late favipiravir therapy (in the latter case, the same regimen starting on day 6 instead of day 1). The primary endpoint was viral clearance by day 6. The secondary endpoint was change in viral load by day 6. Exploratory endpoints included time to defervescence and resolution of symptoms. Eighty-nine patients were enrolled, of whom 69 were virologically evaluable. Viral clearance occurred within 6 days in 66.7% and 56.1% of the early and late treatment groups (adjusted hazard ratio [aHR], 1.42; 95% confidence interval [95% CI], 0.76 to 2.62). Of 30 patients who had a fever (≥37.5°C) on day 1, times to defervescence were 2.1 days and 3.2 days in the early and late treatment groups (aHR, 1.88; 95% CI, 0.81 to 4.35). During therapy, 84.1% developed transient hyperuricemia. Favipiravir did not significantly improve viral clearance as measured by reverse transcription-PCR (RT-PCR) by day 6 but was associated with numerical reduction in time to defervescence. Neither disease progression nor death occurred in any of the patients in either treatment group during the 28-day participation. (This study has been registered with the Japan Registry of Clinical Trials under number jRCTs041190120.).


Subject(s)
Amides/administration & dosage , Antiviral Agents/administration & dosage , COVID-19/drug therapy , Pyrazines/administration & dosage , SARS-CoV-2/drug effects , Viral Load/drug effects , Adolescent , Adult , Amides/adverse effects , Antiviral Agents/adverse effects , Asymptomatic Diseases , COVID-19/physiopathology , COVID-19/virology , Female , Hospitalization , Humans , Hyperuricemia/chemically induced , Hyperuricemia/diagnosis , Hyperuricemia/physiopathology , Japan , Male , Middle Aged , Prospective Studies , Pyrazines/adverse effects , Random Allocation , SARS-CoV-2/pathogenicity , Secondary Prevention/organization & administration , Severity of Illness Index , Time-to-Treatment/organization & administration , Treatment Outcome
5.
Intern Med ; 59(18): 2327-2329, 2020 Sep 15.
Article in English | MEDLINE | ID: covidwho-792260

ABSTRACT

A 42-year-old man exhibiting hypoxia was diagnosed with coronavirus disease 2019. He had medical histories of type 2 diabetes, hyperlipidemia, hyperuricemia, and gout attack. He received favipiravir for compassionate use for 14 days. Subsequently, he showed increased uric acid levels and developed acute gouty arthritis. Favipiravir may induce not only hyperuricemia but also acute gouty arthritis. It should therefore be used with caution in patients with a history of gout and those with hyperuricemia, especially when used at a higher dose and for a longer duration than is typical.


Subject(s)
Amides/adverse effects , Antiviral Agents/adverse effects , Arthritis, Gouty/chemically induced , Betacoronavirus , Coronavirus Infections/drug therapy , Pneumonia, Viral/drug therapy , Pyrazines/adverse effects , Adult , Amides/therapeutic use , Antiviral Agents/therapeutic use , COVID-19 , Coronavirus Infections/complications , Humans , Hyperuricemia/complications , Lung/diagnostic imaging , Lung/pathology , Male , Pandemics , Pneumonia, Viral/complications , Pyrazines/therapeutic use , SARS-CoV-2 , Uric Acid/urine
6.
Infect Dis (Lond) ; 52(6): 423-426, 2020 06.
Article in English | MEDLINE | ID: covidwho-27430

ABSTRACT

A 35-year-old woman presented with fever and mild diarrhoea without any respiratory symptoms 9 days after travelling to Japan from Wuhan, China. Her computed tomography scan revealed pneumonia. The first polymerase chain reaction (PCR) test on throat swab for the novel corona virus upon admission was negative. Therefore, she was treated for community-acquired pneumonia, but fever persisted. On hospital day 5, PCR test on induced sputum was positive, but a second polymerase chain reaction test on throat swab remained negative. She was discharged, fully recovered, on hospital day 12. A lower respiratory tract specimen should be obtained for better diagnosis of corona virus disease 2019, even in the absence of respiratory symptoms for patients with significant travel or exposure history.


Subject(s)
Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Polymerase Chain Reaction , Sputum/virology , Adult , Betacoronavirus , COVID-19 , COVID-19 Testing , COVID-19 Vaccines , China , Clinical Laboratory Techniques , Communicable Diseases, Imported/diagnosis , Communicable Diseases, Imported/virology , Diarrhea/virology , Female , Fever/virology , Humans , Japan , Pandemics , Pharynx/virology , SARS-CoV-2 , Tomography, X-Ray Computed , Travel
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