Diagnosis of COVID-19 pneumonia despite missing detection of viral nucleic acid and initially inconspicuous radiologic findings.
J Med Virol
; 92(11): 2863-2865, 2020 11.
Article
in English
| MEDLINE | ID: covidwho-935139
ABSTRACT
The diagnosis of coronavirus disease 2019 (COVID-19) is mainly based on a positive severe acute respiratory syndrome coronavirus 2 (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 with 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 immunoglobulin G and immunoglobulin A antibodies against the S1 domain of the SARS-CoV-2 spike protein, and the patient was diagnosed with COVID-19 pneumonia.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Tomography, X-Ray Computed
/
COVID-19 Nucleic Acid Testing
/
COVID-19 Serological Testing
/
COVID-19
/
Antibodies, Viral
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
J Med Virol
Year:
2020
Document Type:
Article
Affiliation country:
Jmv.26153
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