Repeated Nucleic Acid Tests Are Necessary for Early Diagnosis of Atypical COVID-19: A Case Report

In Wuhan, China, the first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported on December 8, 2019. The patient’s symptoms included fever, coughing and breathing difficulties. According to the sixth China version of 2019 coronavirus disease (COVID-19) diagnostic criteria, some patients with COVID-19 may present atypical symptoms and have negative nucleic acid tests (NATs), possibly leading to misdiagnosis and viral transmission. Our patient was a 29-year-old woman who complained of a three-day history of nasal obstruction, and no fever, coughing or breathing difficulties were noted. Physical examination revealed no obvious signs of pneumonia. On January 16, 2020, the patient flew from Wuhan to Germany for a business trip and returned to Shanghai on January 28, a passenger on her flight was tested positive for SARS-CoV-2 later. Although two consecutive NATs performed at an interval of 24 h were negative, considering her direct contact with a SARS-CoV-2-infected individual, a 64-slice computed tomography (CT) scan showed a few scattered ground-glass nodules in the left lung, suggesting possible viral pneumonia. Given the clinical characteristics, epidemiological records, CT findings and a third positive NAT, our patient was diagnosed with COVID-19. The combination of history of epidemiology, clinical symptom, lung CT scan and routine blood test will improve the clinical diagnosis of asymptomatic COVID-19, but the early diagnosis of COVID-19 can be confirmed only by the repeated NATs.

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Are RNA-Based Tests Sufficient for COVID-19 Diagnosis? An Inspiration of Three Asymptomatic Cases

Cell Transplantation ◽

10.1177/0963689720985453 ◽

2021 ◽

Vol 30 ◽

pp. 096368972098545

Author(s):

Tao Hu ◽

Xiao Liu ◽

Qinan Yin ◽

Xingting Duan ◽

Li Yan

Keyword(s):

Computed Tomography ◽

Nucleic Acid ◽

Virus Infection ◽

Severe Acute Respiratory Syndrome ◽

The Other ◽

Computed Tomography Scan ◽

Health Authorities ◽

History Of ◽

Tomography Scan ◽

Nucleic Acid Tests

In this work, we discovered a new phenomenon—asymptomatic COVID-19 infection, or covert case, during the pandemic. All the 3 patients had a history of exposure, with no symptoms, and no abnormalities were found in computed tomography scan or lab tests. Except for case 2, the other patients’ severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) nucleic acid tests were negative. But their anti-SARS-COV-2 nucleocapsid antibody showed a dynamic trend, consistent with the process of virus infection and clearance. A growing number of asymptomatic or covert cases need more attention. Lack of surveillance may lead to another outbreak. We hope to demonstrate our cases to attract the attention of governments or health authorities that covert cases should be the focus as well.

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Coincidental Pituitary Adenoma and Parasellar Meningioma: Case Report

Neurosurgery ◽

10.1227/00006123-198608000-00016 ◽

1986 ◽

Vol 19 (2) ◽

pp. 267-270 ◽

Cited By ~ 19

Author(s):

Kenji Yamada ◽

Takashi Hatayama ◽

Masahiro Ohta ◽

Katsuaki Sakoda ◽

Tohru Uozumi

Keyword(s):

Case Report ◽

Pituitary Adenoma ◽

Head Injury ◽

Ct Scan ◽

The Other ◽

Histopathological Findings ◽

Computed Tomographic ◽

First Case ◽

History Of

Abstract We report a patient who had pituitary adenoma and parasellar meningioma coincidentally, with neither irradiation nor a history of head injury. Preoperative computed tomographic (CT) scan had shown a large intrasellar mass with ringlike enhancement; in contact with this mass, another well-enhanced mass had been shown. Histopathologically, the intrasellar mass was diagnosed as chromophobic pituitary adenoma and the other mass as meningotheliomatous meningioma. We present clinical, radiological, and histopathological findings and discuss previously reported cases of coincidental pituitary adenoma and meningioma without irradiation. This is the first case report since the advent of CT that pituitary adenoma and parasellar meningioma in contact with each other could be clearly demonstrated by CT.

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Combination of chest CT and clinical features for diagnosis of 2019 novel coronavirus pneumonia

Open Medicine ◽

10.1515/med-2020-0107 ◽

2020 ◽

Vol 15 (1) ◽

pp. 723-727

Author(s):

Xin Wang ◽

Peng Wen ◽

Zhi-Gang Sun ◽

Chun-Yan Xing ◽

Yun Li

Keyword(s):

Nucleic Acid ◽

Clinical Features ◽

Comprehensive Evaluation ◽

High Sensitivity ◽

Chest Ct ◽

Nucleic Acid Test ◽

First Case ◽

History Of ◽

Novel Coronavirus ◽

Acid Test

AbstractIn December 2019, novel coronavirus pneumonia-19 (COVID-19) was discovered in the viral pneumonia cases that occurred in Wuhan, China, and then quickly spread around the world. This report described the clinical course of two COVID-19 patients and the purpose of the study was to discuss the combination of chest CT and clinical features for diagnosis of COVID-19. The first case was a typical COVID-19 case. A 66-year-old female presented to our hospital with a 3-day history of fever. She had contact with a COVID-19 patient. Chest CT showed a typical COVID-19 appearance. She was diagnosed with COVID-19 by a positive nucleic acid test. The second case was a 50-year-old male with a 2-day history of fever. He denied having been to Wuhan. Chest CT also showed typical features of COVID-19 pneumonia. COVID-19 nucleic acid tests were repeated up to seven times and the results remained controversial. Eventually, he was diagnosed with COVID-19. Our study shows that chest CT has high sensitivity for diagnosis of COVID-19 in clinical practice, particularly when the nucleic acid test is negative. The chest CT should be considered as a diagnostic tool for the COVID-19 screening, comprehensive evaluation, and follow-up and patients would benefit from effective treatments in time.

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Chest CT Could Be Used to Diagnose 2019 Novel Coronavirus Pneumonia Clinically in Hubei Province

10.21203/rs.3.rs-17422/v1 ◽

2020 ◽

Author(s):

Xin Wang ◽

Peng Wen ◽

Zhi-Gang Sun ◽

Chun-Yan Xing ◽

Yun Li

Keyword(s):

Nucleic Acid ◽

Comprehensive Evaluation ◽

Hubei Province ◽

Ct Imaging ◽

Chest Ct ◽

Nucleic Acid Test ◽

First Case ◽

History Of ◽

Novel Coronavirus ◽

Acid Test

Abstract Background: In December 2019, novel coronavirus pneumonia-19 (COVID-19) was discovered in the viral pneumonia cases that occurred in Wuhan, Hubei Province, China; and then quickly spread inside and outside of Wuhan and even other countries. This report describes the clinical course of two patients who had COVID-19.Case presentation: The first case was a typical COVID-19 case. A 66-year-old female presented to our hospital with a 3-day history of fever with coughing, white sputum, runny nose and dizziness. She had contacted with a COVID-19 patient, her daughter-in-law who was diagnosed with COVID-19 two days before. Chest CT showed typical COVID-19 CT imaging. She was diagnosed with COVID-19 by positive nucleic acid test. The second case was a 50-year-old male with a 2-day history of fever and dry coughing. He denied having been to Wuhan. Chest CT also showed typical COVID-19 CT imaging. He accepted COVID-19 nucleic acid test using reverse-transcription polymerase chain reaction of his throat swab sampling 7 times and the test results remained controversial. Eventually, he was diagnosed with COVID-19 after 5 days.Conclusions: Chest CT examination has high sensitivity for diagnosis of COVID-19 clinically, particularly when nucleic acid test is negative. Chest CT should be considered for the COVID-19 screening, comprehensive evaluation and following-up and patients could benefit from effective treatment in time.

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Corona kills corona: convalescent sera option for global war against corona virus disease 2019

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20202022 ◽

2020 ◽

Vol 7 (5) ◽

pp. 2001

Author(s):

Babita . ◽

Anita Punia ◽

S. K. Jha ◽

Mahavir Jangra

Keyword(s):

Nucleic Acid ◽

Severe Acute Respiratory Syndrome ◽

Virus Disease ◽

Hubei Province ◽

Atypical Pneumonia ◽

Corona Virus ◽

First Case ◽

Rna Genome ◽

Global War ◽

Nucleic Acid Tests

On December 31st, 2019 China reported first case of atypical pneumonia in Wuhan, the capital of Hubei province. The causative virus was found to be a beta coronavirus, closely related to the severe acute respiratory syndrome coronavirus (SARS-CoV-1) from 2003 and similar to Sarbeco viruses isolated from bats. It was therefore termed SARS-CoV-2 and the disease was named corona virus disease 2019 (COVID-19). The outbreak in Wuhan expanded quickly and led to the lockdown of Wuhan and other parts of China. While the lockdown, at least temporarily, brought the situation under control in China, but SARS-CoV-2 spread globally causing a pandemic with more than 4 lakh infections and about 19000 fatalities (as of March 25, 2020). Nucleic acid tests that detect the SARS-CoV-2 RNA genome were quickly developed and are now widely employed to diagnose COVID-19.

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A “Crazy Paving” Pattern on CT Scan in a Patient Treated with Pembrolizumab

Current Drug Safety ◽

10.2174/1574886314666190312115648 ◽

2019 ◽

Vol 14 (3) ◽

pp. 242-245

Author(s):

Maurizio Marvisi ◽

Sara Ramponi ◽

Laura Balzarini ◽

Chiara Mancini

Keyword(s):

Ct Scan ◽

Morbidity And Mortality ◽

Great Promise ◽

Significant Morbidity ◽

Exertional Dyspnea ◽

Standard Management ◽

First Case ◽

History Of ◽

Contrast Ct

Background: Programmed cell death protein 1 (PD-1) and its ligand, PD-L1, have shown great promise in clinical practice and have been incorporated into standard management of NSCLC. Pneumonitis is a serious autoimmune toxicity associated with the use of anti-PD-1/PD-L1 antibodies, resulting in significant morbidity and mortality. Methods: We described the case of a 73-year-old woman with no history of smoking developing exertional dyspnea four months after taking Pembrolizumab. Results: High resolution contrast CT scan (HRCT) presented a unilateral “crazy paving” pattern, and bronchoalveolar lavage (BAL) an important lymphocytosis (20% of total cell count). The patient reached clinical stability after the administration of systemic steroids (2mg\Kg\die) and was discharged with long term oxygen therap Discussion: Pulmonary toxicity is frequent when using PD-1 inhibitors, resulting in significant morbidity and mortality, often leading to the discontinuation of therapy. Clinical presentation is usually protean and HRCT pattern is nonspecific. This is the first case presenting a “crazy paving” pattern associated with BAL lymphocytosis. Conclusion: Oncologists, pulmonologists, radiologists and general practitioners have to consider PD-1 and PD-L1 inhibitor pneumonitis as a potentially disabling and fatal event.

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The Positive Rate of Nucleic Acid Testing and the Epidemiological Characteristics of COVID-19 in Chongqing

Frontiers in Medicine ◽

10.3389/fmed.2021.802708 ◽

2022 ◽

Vol 8 ◽

Author(s):

Xiaohua Liang ◽

Yajun Sun ◽

Lun Xiao ◽

YanLing Ren ◽

Xian Tang

Keyword(s):

Nucleic Acid ◽

Nucleic Acid Testing ◽

Asymptomatic Carriers ◽

First Case ◽

Latency Range ◽

Increased Risk ◽

Positive Rate ◽

Epidemiological Characteristics ◽

Close Contacts ◽

Nucleic Acid Tests

ObjectiveThe purpose of this study is to analyze the positive rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid testing (NAT), cases of and deaths due to SARS-CoV-2, and the epidemiological characteristics of SARS-CoV-2 to identify high-risk populations.MethodsA retrospective study in Jiulongpo district of Chongqing was conducted by performing continuous observations of the frequency of SARS-CoV-2 NAT, analyzing the data of close contacts of patients and asymptomatic carriers, and collecting epidemiological data. Data were collected from January 20, 2020, when the first case of SARS-CoV-2 infection was reported, to March 26, 2020. Descriptive statistical analysis and Cochrane–Mantel–Haenszel analysis were used to compare the positive detection rates and positive diagnostic rates of different exposure groups.ResultsA total of 7,118 people received 10,377 SARS-CoV-2 nucleic acid tests in one district, and the SARS-CoV-2 positive rates were 0.40% (18/4446) and 0.15% (4/2672) in people receiving one and ≥ two nucleic acid tests (p = 0.06), respectively. Those with suspected cases (12.35%) and close contacts (8%) had higher positive rates than people tested at fever clinics (0.39%) (p < 0.001). The median latency (range) of cases was 5 (2, 9) days, and the median time from diagnosis to recovery was 22 (14, 25) days. One recovered patient received a positive test result at 28 days after recovery when she attempted to donate blood. Six clustered cases, including one patient who died, indicated persistent human-to-human transmission. One patient who was diagnosed after death was found to have infected 13 close contacts. People working in catering and other public service departments (36.36%) and people who are unemployed and retirees (45.45%) have an increased risk of infection compared with technical staff (9.09%) and farmers (9.09%).ConclusionThe total positive rate was low in the tested population, and more effective detection ranges should be defined to improve precise and differentiated epidemic control strategies. Moreover, in asymptomatic carriers, SARS-CoV-2 tests were positive after recovery, and patients with suspected SARS-CoV-2 infection who die may pose serious potential transmission threats.

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Case Report: Management of a Patient with mTBI and Vestibular Hypofunction with the Binasal Occlusion Technique

Vision Development & Rehabilitation ◽

10.31707/vdr2018.4.2.p87 ◽

2018 ◽

pp. 87-90

Keyword(s):

Case Report ◽

Visual Motion ◽

Hand Movement ◽

Motion Sensitivity ◽

Vestibular Hypofunction ◽

First Case ◽

Neurological Exam ◽

History Of ◽

Occlusion Technique ◽

Visual Vertigo

Background: Binasal Occlusion (BNO) is a clinical technique used by many neurorehabilitative optometrists in patients with mild traumatic brain injury (mTBI) and increased visual motion sensitivity (VMS) or visual vertigo. BNO is a technique in which partial occluders are added to the spectacle lenses to suppress the abnormal peripheral visual motion information. This technique helps in reducing VMS symptoms (i.e., nausea, dizziness, balance difficulty, visual confusion). Case Report: A 44-year-old AA female presented for a routine eye exam with a history of mTBI approximately 33 years ago. She was suffering from severe dizziness for the last two years that was adversely impacting her ADLs. The dizziness occurred in all body positions and all environments throughout the day. She was diagnosed with vestibular hypofunction and had undergone vestibular therapy but reported little improvement. Neurological exam revealed dizziness with both OKN drum and hand movement, especially in the left visual field. BNO technique resulted in immediate relief of her dizziness symptoms. Conclusion: To our knowledge, this is the first case that illustrates how the BNO technique in isolation can be beneficial for patients with mTBI and vestibular hypofunction. It demonstrates the success that BNO has in filtering abnormal peripheral visual motion in these patients.

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Scales and Units

10.1093/oso/9780190657543.003.0011 ◽

2018 ◽

Author(s):

Kathryn M. de Luna

Keyword(s):

Language Change ◽

Historical Linguistics ◽

Bantu Languages ◽

The North ◽

First Case ◽

Linguistic Evidence ◽

River Region ◽

History Of ◽

Alternative Approaches

This chapter uses two case studies to explore how historians study language movement and change through comparative historical linguistics. The first case study stands as a short chapter in the larger history of the expansion of Bantu languages across eastern, central, and southern Africa. It focuses on the expansion of proto-Kafue, ca. 950–1250, from a linguistic homeland in the middle Kafue River region to lands beyond the Lukanga swamps to the north and the Zambezi River to the south. This expansion was made possible by a dramatic reconfiguration of ties of kinship. The second case study explores linguistic evidence for ridicule along the Lozi-Botatwe frontier in the mid- to late 19th century. Significantly, the units and scales of language movement and change in precolonial periods rendered visible through comparative historical linguistics bring to our attention alternative approaches to language change and movement in contemporary Africa.

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