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Diagnosis of COVID-19 pneumonia despite missing detection of viral nucleic acid and initially inconspicuous radiologic findings.
Schiller, Martin; Wydra, Stephan; Kerl, Hans Ulrich; Kick, Wolfgang.
  • Schiller M; HochFranken Hospitals, Internal Medicine, Munchberg, Germany.
  • Wydra S; Bioscientia Institute for Medical Diagnostics GmbH, Jena, Germany.
  • Kerl HU; HochFranken Hospitals, Radiology, Munchberg, Germany.
  • Kick W; HochFranken Hospitals, Internal Medicine, Munchberg, Germany.
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.
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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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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