The clinical manifestations and interval changes of reverse-transcriptase quantitative polymerase chain reactions among different specimens of coronavirus disease 2019 patients.
Identifieur interne : 000850 ( Main/Corpus ); précédent : 000849; suivant : 000851The clinical manifestations and interval changes of reverse-transcriptase quantitative polymerase chain reactions among different specimens of coronavirus disease 2019 patients.
Auteurs : Po-Liang Chen ; Yi-Han Hsiao ; Chien Chuang ; Jia-Yih Feng ; Hsiang-Ling Ho ; Yi-Tsung Lin ; Su-Jung Chen ; Shiang-Fen Huang ; Hsin-Pai Chen ; Teh-Ying Chou ; Yuh-Min Chen ; Fu-Der WangSource :
- Journal of the Chinese Medical Association : JCMA [ 1728-7731 ] ; 2021.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Azithromycin (administration & dosage), COVID-19 (complications), COVID-19 (drug therapy), COVID-19 (virology), Female (MeSH), Humans (MeSH), Hydroxychloroquine (administration & dosage), Hydroxychloroquine (therapeutic use), Male (MeSH), Middle Aged (MeSH), Reverse Transcriptase Polymerase Chain Reaction (methods), SARS-CoV-2 (MeSH), Viral Load (MeSH).
- MESH :
- chemical , administration & dosage : Azithromycin, Hydroxychloroquine.
- complications : COVID-19.
- drug therapy : COVID-19.
- methods : Reverse Transcriptase Polymerase Chain Reaction.
- chemical , therapeutic use : Hydroxychloroquine.
- virology : COVID-19.
- Adult, Aged, Female, Humans, Male, Middle Aged, SARS-CoV-2, Viral Load.
Abstract
BACKGROUND
Since December 2019, a number of cases and deaths due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have been reported worldwide. In spite of clinical manifestations similar to the SARS-CoV epidemic in 2003, affected organs and severity are yet to be defined. Moreover, viral load alterations and viral shielding among different specimens remained scarce. Therefore, clarifying clinical presentations and correlations among viral loads, disease severity, and viral shielding of SARS-CoV-2 infection is crucial in the disease prevention.
METHODS
The clinical courses of SARS-CoV-2 cases were presented through Gantt charts. Laboratory examinations and reverse-transcriptase quantitative polymerase chain reactions (RT-qPCR) among different specimens were tested periodically. Cycle thresholds (CT) were recorded and presented as viral loads.
RESULTS
From March 2020 to April 2020, 4 SARS-CoV-2 cases were presented, of which, cases 1 and 2 manifested the symptoms severer than cases 3 and 4, along with higher serum lactate dehydrogenase levels and graded for lymphocytopenia. Case 4 initially exhibited anosmia but recovered within a short period. Curves of the CT of all the cases, except case 2, concaved upward after prescribing hydroxychloroquine (HCQ) and azithromycin. Except for case 4, the CT in most stool specimens remained undetectable; however, none of the cases presented gastrointestinal symptoms. Surprisingly, the CT values of the saliva specimens were inconsistent with those of the nasopharyngeal swabs and sputum.
CONCLUSION
SARS-CoV-2 manifests various symptoms. Sudden onset of central nervous system symptoms should be considered. The timing of HCQ and azithromycin administration might be a key factor in the viral load reduction. Positive prediction values of RT-qPCR of different specimens should be tested carefully to prevent false-negative results.
DOI: 10.1097/JCMA.0000000000000451
PubMed: 33177406
Links to Exploration step
pubmed:33177406Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The clinical manifestations and interval changes of reverse-transcriptase quantitative polymerase chain reactions among different specimens of coronavirus disease 2019 patients.</title><author><name sortKey="Chen, Po Liang" sort="Chen, Po Liang" uniqKey="Chen P" first="Po-Liang" last="Chen">Po-Liang Chen</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Hsiao, Yi Han" sort="Hsiao, Yi Han" uniqKey="Hsiao Y" first="Yi-Han" last="Hsiao">Yi-Han Hsiao</name><affiliation><nlm:affiliation>Division of General Chest Medicine, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Chuang, Chien" sort="Chuang, Chien" uniqKey="Chuang C" first="Chien" last="Chuang">Chien Chuang</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Feng, Jia Yih" sort="Feng, Jia Yih" uniqKey="Feng J" first="Jia-Yih" last="Feng">Jia-Yih Feng</name><affiliation><nlm:affiliation>Division of Pulmonary Immunology & Infectious Disease, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Ho, Hsiang Ling" sort="Ho, Hsiang Ling" uniqKey="Ho H" first="Hsiang-Ling" last="Ho">Hsiang-Ling Ho</name><affiliation><nlm:affiliation>Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Division of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Lin, Yi Tsung" sort="Lin, Yi Tsung" uniqKey="Lin Y" first="Yi-Tsung" last="Lin">Yi-Tsung Lin</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Su Jung" sort="Chen, Su Jung" uniqKey="Chen S" first="Su-Jung" last="Chen">Su-Jung Chen</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, Shiang Fen" sort="Huang, Shiang Fen" uniqKey="Huang S" first="Shiang-Fen" last="Huang">Shiang-Fen Huang</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Hsin Pai" sort="Chen, Hsin Pai" uniqKey="Chen H" first="Hsin-Pai" last="Chen">Hsin-Pai Chen</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Chou, Teh Ying" sort="Chou, Teh Ying" uniqKey="Chou T" first="Teh-Ying" last="Chou">Teh-Ying Chou</name><affiliation><nlm:affiliation>Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Yuh Min" sort="Chen, Yuh Min" uniqKey="Chen Y" first="Yuh-Min" last="Chen">Yuh-Min Chen</name><affiliation><nlm:affiliation>Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Fu Der" sort="Wang, Fu Der" uniqKey="Wang F" first="Fu-Der" last="Wang">Fu-Der Wang</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33177406</idno><idno type="pmid">33177406</idno><idno type="doi">10.1097/JCMA.0000000000000451</idno><idno type="wicri:Area/Main/Corpus">000850</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000850</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The clinical manifestations and interval changes of reverse-transcriptase quantitative polymerase chain reactions among different specimens of coronavirus disease 2019 patients.</title><author><name sortKey="Chen, Po Liang" sort="Chen, Po Liang" uniqKey="Chen P" first="Po-Liang" last="Chen">Po-Liang Chen</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Hsiao, Yi Han" sort="Hsiao, Yi Han" uniqKey="Hsiao Y" first="Yi-Han" last="Hsiao">Yi-Han Hsiao</name><affiliation><nlm:affiliation>Division of General Chest Medicine, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Chuang, Chien" sort="Chuang, Chien" uniqKey="Chuang C" first="Chien" last="Chuang">Chien Chuang</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Feng, Jia Yih" sort="Feng, Jia Yih" uniqKey="Feng J" first="Jia-Yih" last="Feng">Jia-Yih Feng</name><affiliation><nlm:affiliation>Division of Pulmonary Immunology & Infectious Disease, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Ho, Hsiang Ling" sort="Ho, Hsiang Ling" uniqKey="Ho H" first="Hsiang-Ling" last="Ho">Hsiang-Ling Ho</name><affiliation><nlm:affiliation>Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Division of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Lin, Yi Tsung" sort="Lin, Yi Tsung" uniqKey="Lin Y" first="Yi-Tsung" last="Lin">Yi-Tsung Lin</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Su Jung" sort="Chen, Su Jung" uniqKey="Chen S" first="Su-Jung" last="Chen">Su-Jung Chen</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, Shiang Fen" sort="Huang, Shiang Fen" uniqKey="Huang S" first="Shiang-Fen" last="Huang">Shiang-Fen Huang</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Hsin Pai" sort="Chen, Hsin Pai" uniqKey="Chen H" first="Hsin-Pai" last="Chen">Hsin-Pai Chen</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Chou, Teh Ying" sort="Chou, Teh Ying" uniqKey="Chou T" first="Teh-Ying" last="Chou">Teh-Ying Chou</name><affiliation><nlm:affiliation>Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Yuh Min" sort="Chen, Yuh Min" uniqKey="Chen Y" first="Yuh-Min" last="Chen">Yuh-Min Chen</name><affiliation><nlm:affiliation>Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Fu Der" sort="Wang, Fu Der" uniqKey="Wang F" first="Fu-Der" last="Wang">Fu-Der Wang</name><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Journal of the Chinese Medical Association : JCMA</title><idno type="eISSN">1728-7731</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Azithromycin (administration & dosage)</term><term>COVID-19 (complications)</term><term>COVID-19 (drug therapy)</term><term>COVID-19 (virology)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (administration & dosage)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Reverse Transcriptase Polymerase Chain Reaction (methods)</term><term>SARS-CoV-2 (MeSH)</term><term>Viral Load (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Azithromycin</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Reverse Transcriptase Polymerase Chain Reaction</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>SARS-CoV-2</term><term>Viral Load</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Since December 2019, a number of cases and deaths due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have been reported worldwide. In spite of clinical manifestations similar to the SARS-CoV epidemic in 2003, affected organs and severity are yet to be defined. Moreover, viral load alterations and viral shielding among different specimens remained scarce. Therefore, clarifying clinical presentations and correlations among viral loads, disease severity, and viral shielding of SARS-CoV-2 infection is crucial in the disease prevention.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>The clinical courses of SARS-CoV-2 cases were presented through Gantt charts. Laboratory examinations and reverse-transcriptase quantitative polymerase chain reactions (RT-qPCR) among different specimens were tested periodically. Cycle thresholds (CT) were recorded and presented as viral loads.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>From March 2020 to April 2020, 4 SARS-CoV-2 cases were presented, of which, cases 1 and 2 manifested the symptoms severer than cases 3 and 4, along with higher serum lactate dehydrogenase levels and graded for lymphocytopenia. Case 4 initially exhibited anosmia but recovered within a short period. Curves of the CT of all the cases, except case 2, concaved upward after prescribing hydroxychloroquine (HCQ) and azithromycin. Except for case 4, the CT in most stool specimens remained undetectable; however, none of the cases presented gastrointestinal symptoms. Surprisingly, the CT values of the saliva specimens were inconsistent with those of the nasopharyngeal swabs and sputum.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>SARS-CoV-2 manifests various symptoms. Sudden onset of central nervous system symptoms should be considered. The timing of HCQ and azithromycin administration might be a key factor in the viral load reduction. Positive prediction values of RT-qPCR of different specimens should be tested carefully to prevent false-negative results.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33177406</PMID><DateCompleted><Year>2021</Year><Month>02</Month><Day>15</Day></DateCompleted><DateRevised><Year>2021</Year><Month>02</Month><Day>15</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1728-7731</ISSN><JournalIssue CitedMedium="Internet"><Volume>84</Volume><Issue>2</Issue><PubDate><Year>2021</Year><Month>02</Month><Day>01</Day></PubDate></JournalIssue><Title>Journal of the Chinese Medical Association : JCMA</Title><ISOAbbreviation>J Chin Med Assoc</ISOAbbreviation></Journal><ArticleTitle>The clinical manifestations and interval changes of reverse-transcriptase quantitative polymerase chain reactions among different specimens of coronavirus disease 2019 patients.</ArticleTitle><Pagination><MedlinePgn>151-157</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/JCMA.0000000000000451</ELocationID><Abstract><AbstractText Label="BACKGROUND">Since December 2019, a number of cases and deaths due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have been reported worldwide. In spite of clinical manifestations similar to the SARS-CoV epidemic in 2003, affected organs and severity are yet to be defined. Moreover, viral load alterations and viral shielding among different specimens remained scarce. Therefore, clarifying clinical presentations and correlations among viral loads, disease severity, and viral shielding of SARS-CoV-2 infection is crucial in the disease prevention.</AbstractText><AbstractText Label="METHODS">The clinical courses of SARS-CoV-2 cases were presented through Gantt charts. Laboratory examinations and reverse-transcriptase quantitative polymerase chain reactions (RT-qPCR) among different specimens were tested periodically. Cycle thresholds (CT) were recorded and presented as viral loads.</AbstractText><AbstractText Label="RESULTS">From March 2020 to April 2020, 4 SARS-CoV-2 cases were presented, of which, cases 1 and 2 manifested the symptoms severer than cases 3 and 4, along with higher serum lactate dehydrogenase levels and graded for lymphocytopenia. Case 4 initially exhibited anosmia but recovered within a short period. Curves of the CT of all the cases, except case 2, concaved upward after prescribing hydroxychloroquine (HCQ) and azithromycin. Except for case 4, the CT in most stool specimens remained undetectable; however, none of the cases presented gastrointestinal symptoms. Surprisingly, the CT values of the saliva specimens were inconsistent with those of the nasopharyngeal swabs and sputum.</AbstractText><AbstractText Label="CONCLUSION">SARS-CoV-2 manifests various symptoms. Sudden onset of central nervous system symptoms should be considered. The timing of HCQ and azithromycin administration might be a key factor in the viral load reduction. Positive prediction values of RT-qPCR of different specimens should be tested carefully to prevent false-negative results.</AbstractText><CopyrightInformation>Copyright © 2020, the Chinese Medical Association.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Po-Liang</ForeName><Initials>PL</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hsiao</LastName><ForeName>Yi-Han</ForeName><Initials>YH</Initials><AffiliationInfo><Affiliation>Division of General Chest Medicine, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chuang</LastName><ForeName>Chien</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Feng</LastName><ForeName>Jia-Yih</ForeName><Initials>JY</Initials><AffiliationInfo><Affiliation>Division of Pulmonary Immunology & Infectious Disease, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ho</LastName><ForeName>Hsiang-Ling</ForeName><Initials>HL</Initials><AffiliationInfo><Affiliation>Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lin</LastName><ForeName>Yi-Tsung</ForeName><Initials>YT</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Su-Jung</ForeName><Initials>SJ</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Huang</LastName><ForeName>Shiang-Fen</ForeName><Initials>SF</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Hsin-Pai</ForeName><Initials>HP</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chou</LastName><ForeName>Teh-Ying</ForeName><Initials>TY</Initials><AffiliationInfo><Affiliation>Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Yuh-Min</ForeName><Initials>YM</Initials><AffiliationInfo><Affiliation>Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Fu-Der</ForeName><Initials>FD</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>J Chin Med Assoc</MedlineTA><NlmUniqueID>101174817</NlmUniqueID><ISSNLinking>1726-4901</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical><Chemical><RegistryNumber>83905-01-5</RegistryNumber><NameOfSubstance UI="D017963">Azithromycin</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017963" MajorTopicYN="N">Azithromycin</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020133" MajorTopicYN="N">Reverse Transcriptase Polymerase Chain Reaction</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="Y">SARS-CoV-2</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019562" MajorTopicYN="Y">Viral Load</DescriptorName></MeshHeading></MeshHeadingList><CoiStatement>The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>11</Month><Day>13</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>2</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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