Diagnosis of COVID-19 pneumonia despite missing detection of viral nucleic acid and initially inconspicuous radiologic findings.
J Med Virol. 2020 Jun 10;:
Authors: Schiller M, Wydra S, Kerl HU, Kick W
The diagnosis of coronavirus disease 2019 (COVID-19) is mainly based on a positive 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 to 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 IgG and IgA antibodies against the S1 domain of the SARS-CoV-2 spike protein and the patient was diagnosed with COVID-19 pneumonia. This article is protected by copyright. All rights reserved.
PMID: 32519760 [PubMed - as supplied by publisher]