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A case of primary COVID-19 pneumonia: plausible airborne transmission of SARS-CoV-2.
Dumont-Leblond, Nathan; Duchaine, Caroline; Veillette, Marc; Pen, Visal; Bergevin, Marco.
  • Dumont-Leblond N; Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC, Canada.
  • Duchaine C; Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC, Canada.
  • Veillette M; Département de Biochimie, Université Laval, de microbiologie et de bio-informatique, Faculté des sciences et de génie, Quebec, QC, Canada.
  • Pen V; Canada Research Chair On Bioaerosols, Quebec, QC, Canada.
  • Bergevin M; Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC, Canada.
Eur J Med Res ; 27(1): 50, 2022 Apr 04.
Article in English | MEDLINE | ID: covidwho-1775349
ABSTRACT

BACKGROUND:

The different clinical manifestations, from none to severe, and the variability in efficacy of SARS-CoV-2 diagnosis by upper respiratory tract testing, make diagnosis of COVID-19 and prevention of transmission especially challenging. In addition, the ways by which the virus can most efficiently transmit still remain unclear. CASE PRESENTATION We report the case a 48-year-old man who presents primary COVID-19 pneumonia. He was initially admitted for cholecystitis but, upon review of his abdominal CT scan, a segmental zone of ground glass opacity was identified in the right lower lobe. A bronchoalveolar lavage proved positive to SARS-CoV-2 by RT-qPCR, even if he tested negative by oro-nasopharyngeal swab at admission and the day after he underwent bronchoscopy. The near absence of the virus in his saliva 2 days after, combined with a very sharp increase in salivary viral load on the third day, also rule out the possibility of prior viral replication in the upper airway and clearance. In addition, rapidly increasing bilateral alveolar lung infiltrates appeared as the upper respiratory tests begin to detect the virus.

CONCLUSIONS:

For this patient to have developed primary COVID-19 pneumonia, a contagious aerosol must have traveled to the lower respiratory system. This case gives indirect but compelling evidence that aerosol may spread the virus. It also highlights the limitations of oral and nasal testing methods and the importance of anatomical considerations when studying infections by SARS-CoV-2.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Limits: Humans / Male / Middle aged Language: English Journal: Eur J Med Res Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: S40001-022-00668-1

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Limits: Humans / Male / Middle aged Language: English Journal: Eur J Med Res Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: S40001-022-00668-1