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Clinical and virological data of the first cases of COVID-19 in Europe: a case series
- Source :
- The Lancet Infectious Diseases, The Lancet Infectious Diseases, 2020, pp.S1473-3099(20)30200-0. ⟨10.1016/S1473-3099(20)30200-0⟩, The Lancet Infectious Diseases, New York, NY : Elsevier Science ; The Lancet Pub. Group, 2001-, 2020, pp.S1473-3099(20)30200-0. ⟨10.1016/S1473-3099(20)30200-0⟩
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- International audience; BACKGROUND:On Dec 31, 2019, China reported a cluster of cases of pneumonia in people at Wuhan, Hubei Province. The responsible pathogen is a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report the relevant features of the first cases in Europe of confirmed infection, named coronavirus disease 2019 (COVID-19), with the first patient diagnosed with the disease on Jan 24, 2020.METHODS:In this case series, we followed five patients admitted to Bichat-Claude Bernard University Hospital (Paris, France) and Pellegrin University Hospital (Bordeaux, France) and diagnosed with COVID-19 by semi-quantitative RT-PCR on nasopharyngeal swabs. We assessed patterns of clinical disease and viral load from different samples (nasopharyngeal and blood, urine, and stool samples), which were obtained once daily for 3 days from hospital admission, and once every 2 or 3 days until patient discharge. All samples were refrigerated and shipped to laboratories in the National Reference Center for Respiratory Viruses (The Institut Pasteur, Paris, and Hospices Civils de Lyon, Lyon, France), where RNA extraction, real-time RT-PCR, and virus isolation and titration procedures were done.FINDINGS:The patients were three men (aged 31 years, 48 years, and 80 years) and two women (aged 30 years and 46 years), all of Chinese origin, who had travelled to France from China around mid-January, 2020. Three different clinical evolutions are described: (1) two paucisymptomatic women diagnosed within a day of exhibiting symptoms, with high nasopharyngeal titres of SARS-CoV-2 within the first 24 h of the illness onset (5·2 and 7·4 log10 copies per 1000 cells, respectively) and viral RNA detection in stools; (2) a two-step disease progression in two young men, with a secondary worsening around 10 days after disease onset despite a decreasing viral load in nasopharyngeal samples; and (3) an 80-year-old man with a rapid evolution towards multiple organ failure and a persistent high viral load in lower and upper respiratory tract with systemic virus dissemination and virus detection in plasma. The 80-year-old patient died on day 14 of illness (Feb 14, 2020); all other patients had recovered and been discharged by Feb 19, 2020.INTERPRETATION:We illustrated three different clinical and biological types of evolution in five patients infected with SARS-CoV-2 with detailed and comprehensive viral sampling strategy. We believe that these findings will contribute to a better understanding of the natural history of the disease and will contribute to advances in the implementation of more efficient infection control strategies.
- Subjects :
- Adult
Male
0301 basic medicine
China
Pediatrics
medicine.medical_specialty
Pneumonia, Viral
Disease
Urine
medicine.disease_cause
Virus
IDLIC
Betacoronavirus
Feces
03 medical and health sciences
0302 clinical medicine
Nasopharynx
Pandemic
medicine
Humans
Infection control
030212 general & internal medicine
Pandemics
Coronavirus
Aged, 80 and over
[SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology
[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases
Travel
[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases
SARS-CoV-2
business.industry
COVID-19
Middle Aged
Viral Load
medicine.disease
3. Good health
Natural history
Pneumonia
Blood
030104 developmental biology
Infectious Diseases
[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology
RNA, Viral
Female
France
Coronavirus Infections
business
Viral load
Subjects
Details
- ISSN :
- 14733099 and 14744457
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- The Lancet Infectious Diseases
- Accession number :
- edsair.doi.dedup.....d2b04a723627af04e63f9624424a5a9f