1. Suspected SARS-CoV-2 infection with fever and coronary heart disease: A case report
- Author
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Jia Liu, Kang-Hui Yu, Ruilin Sun, Jia-sheng Yang, Yao-wei He, and Jin-ru Gong
- Subjects
medicine.medical_specialty ,Serological antibody detection ,medicine.medical_treatment ,Gastroenterology ,Serology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Case report ,medicine ,Stage (cooking) ,medicine.diagnostic_test ,business.industry ,Bacterial pneumonia ,COVID-19 ,Outbreak ,Percutaneous coronary intervention ,Nucleic acid test ,Gold standard (test) ,General Medicine ,medicine.disease ,030220 oncology & carcinogenesis ,Emerging infectious disease ,030211 gastroenterology & hepatology ,Ground-glass opacities ,business ,Suspected case - Abstract
Background The coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Suspected cases accounted for a large proportion in the early stage of the COVID-19 outbreak. The deviation of the nucleic acid test by throat swab (the current gold standard of COVID-19) caused by variation in sampling techniques and reagent kits and coupled with nonspecific clinical manifestations make confirmation of the suspected cases difficult. Proper management of the suspected cases of COVID-19 is crucial for disease control. Case summary A 65-year-old male presented with fever, lymphopenia, and chest computed tomography (CT) images similar to COVID-19 after percutaneous coronary intervention. The patient was diagnosed as having bacterial pneumonia with cardiogenic pulmonary edema instead of COVID-19. This was based on four negative results for throat swab detection of SARS-CoV-2 nucleic acid using reverse transcriptase-polymerase chain reaction assay and one negative result for serological antibody of SARS-CoV-2 with the serological assay. Additionally, the distribution of ground-glass opacities and thickened blood vessels from the CT images differed from COVID-19 features, which further supported the exclusion of COVID-19. Conclusion Distinguishing COVID-19 patients from those with bacterial pneumonia with cardiogenic pulmonary edema can be difficult. Therefore, it requires serious identification.
- Published
- 2020