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The clinical manifestations and interval changes of reverse-transcriptase quantitative polymerase chain reactions among different specimens of coronavirus disease 2019 patients.
Chen, Po-Liang; Hsiao, Yi-Han; Chuang, Chien; Feng, Jia-Yih; Ho, Hsiang-Ling; Lin, Yi-Tsung; Chen, Su-Jung; Huang, Shiang-Fen; Chen, Hsin-Pai; Chou, Teh-Ying; Chen, Yuh-Min; Wang, Fu-Der.
  • Chen PL; Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Hsiao YH; Division of General Chest Medicine, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Chuang C; Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Feng JY; Division of Pulmonary Immunology & Infectious Disease, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Ho HL; Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Lin YT; Division of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
  • Chen SJ; Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Huang SF; Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
  • Chen HP; Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Chou TY; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
  • Chen YM; Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Wang FD; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
J Chin Med Assoc ; 84(2): 151-157, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-1066457
ABSTRACT

BACKGROUND:

Since December 2019, a number of cases and deaths due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have been reported worldwide. In spite of clinical manifestations similar to the SARS-CoV epidemic in 2003, affected organs and severity are yet to be defined. Moreover, viral load alterations and viral shielding among different specimens remained scarce. Therefore, clarifying clinical presentations and correlations among viral loads, disease severity, and viral shielding of SARS-CoV-2 infection is crucial in the disease prevention.

METHODS:

The clinical courses of SARS-CoV-2 cases were presented through Gantt charts. Laboratory examinations and reverse-transcriptase quantitative polymerase chain reactions (RT-qPCR) among different specimens were tested periodically. Cycle thresholds (CT) were recorded and presented as viral loads.

RESULTS:

From March 2020 to April 2020, 4 SARS-CoV-2 cases were presented, of which, cases 1 and 2 manifested the symptoms severer than cases 3 and 4, along with higher serum lactate dehydrogenase levels and graded for lymphocytopenia. Case 4 initially exhibited anosmia but recovered within a short period. Curves of the CT of all the cases, except case 2, concaved upward after prescribing hydroxychloroquine (HCQ) and azithromycin. Except for case 4, the CT in most stool specimens remained undetectable; however, none of the cases presented gastrointestinal symptoms. Surprisingly, the CT values of the saliva specimens were inconsistent with those of the nasopharyngeal swabs and sputum.

CONCLUSION:

SARS-CoV-2 manifests various symptoms. Sudden onset of central nervous system symptoms should be considered. The timing of HCQ and azithromycin administration might be a key factor in the viral load reduction. Positive prediction values of RT-qPCR of different specimens should be tested carefully to prevent false-negative results.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Viral Load / Reverse Transcriptase Polymerase Chain Reaction / SARS-CoV-2 / COVID-19 Type of study: Case report / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: J Chin Med Assoc Journal subject: Medicine Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Viral Load / Reverse Transcriptase Polymerase Chain Reaction / SARS-CoV-2 / COVID-19 Type of study: Case report / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: J Chin Med Assoc Journal subject: Medicine Year: 2021 Document Type: Article