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The clinical manifestations and interval changes of reverse-transcriptase quantitative polymerase chain reactions among different specimens of coronavirus disease 2019 patients.

Identifieur interne : 000095 ( Main/Exploration ); précédent : 000094; suivant : 000096

The clinical manifestations and interval changes of reverse-transcriptase quantitative polymerase chain reactions among different specimens of coronavirus disease 2019 patients.

Auteurs : Po-Liang Chen [République populaire de Chine] ; Yi-Han Hsiao [République populaire de Chine] ; Chien Chuang [République populaire de Chine] ; Jia-Yih Feng [République populaire de Chine] ; Hsiang-Ling Ho [République populaire de Chine] ; Yi-Tsung Lin [République populaire de Chine] ; Su-Jung Chen [République populaire de Chine] ; Shiang-Fen Huang [République populaire de Chine] ; Hsin-Pai Chen [République populaire de Chine] ; Teh-Ying Chou [République populaire de Chine] ; Yuh-Min Chen [République populaire de Chine] ; Fu-Der Wang [République populaire de Chine]

Source :

RBID : pubmed:33177406

Descripteurs français

English descriptors

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


Affiliations:


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<name sortKey="Chuang, Chien" sort="Chuang, Chien" uniqKey="Chuang C" first="Chien" last="Chuang">Chien Chuang</name>
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<nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation>
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<name sortKey="Feng, Jia Yih" sort="Feng, Jia Yih" uniqKey="Feng J" first="Jia-Yih" last="Feng">Jia-Yih Feng</name>
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<nlm:affiliation>Division of Pulmonary Immunology & Infectious Disease, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation>
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<nlm:affiliation>Division of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation>
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<wicri:regionArea>Division of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan</wicri:regionArea>
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<wicri:regionArea>Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan</wicri:regionArea>
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<name sortKey="Chen, Hsin Pai" sort="Chen, Hsin Pai" uniqKey="Chen H" first="Hsin-Pai" last="Chen">Hsin-Pai Chen</name>
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<wicri:regionArea>School of Medicine, National Yang-Ming University, Taipei, Taiwan</wicri:regionArea>
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<name sortKey="Chou, Teh Ying" sort="Chou, Teh Ying" uniqKey="Chou T" first="Teh-Ying" last="Chou">Teh-Ying Chou</name>
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<wicri:regionArea>Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan</wicri:regionArea>
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<wicri:regionArea>Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan</wicri:regionArea>
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<name sortKey="Chen, Yuh Min" sort="Chen, Yuh Min" uniqKey="Chen Y" first="Yuh-Min" last="Chen">Yuh-Min Chen</name>
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<nlm:affiliation>Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation>
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<wicri:regionArea>Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan</wicri:regionArea>
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<nlm:affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation>
<country xml:lang="fr" wicri:curation="lc">République populaire de Chine</country>
<wicri:regionArea>School of Medicine, National Yang-Ming University, Taipei, Taiwan</wicri:regionArea>
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<name sortKey="Wang, Fu Der" sort="Wang, Fu Der" uniqKey="Wang F" first="Fu-Der" last="Wang">Fu-Der Wang</name>
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<nlm:affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</nlm:affiliation>
<country xml:lang="fr" wicri:curation="lc">République populaire de Chine</country>
<wicri:regionArea>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan</wicri:regionArea>
<wicri:noRegion>Taiwan</wicri:noRegion>
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<nlm:affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</nlm:affiliation>
<country xml:lang="fr" wicri:curation="lc">République populaire de Chine</country>
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<title level="j">Journal of the Chinese Medical Association : JCMA</title>
<idno type="eISSN">1728-7731</idno>
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<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>
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<term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Azithromycine (administration et posologie)</term>
<term>Charge virale (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Hydroxychloroquine (administration et posologie)</term>
<term>Hydroxychloroquine (usage thérapeutique)</term>
<term>Mâle (MeSH)</term>
<term>RT-PCR (méthodes)</term>
<term>Sujet âgé (MeSH)</term>
</keywords>
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<term>Azithromycin</term>
<term>Hydroxychloroquine</term>
</keywords>
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<term>Azithromycine</term>
<term>Hydroxychloroquine</term>
</keywords>
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<term>COVID-19</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en">
<term>COVID-19</term>
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<term>Reverse Transcriptase Polymerase Chain Reaction</term>
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<term>RT-PCR</term>
</keywords>
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<term>Hydroxychloroquine</term>
</keywords>
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<term>Hydroxychloroquine</term>
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<term>COVID-19</term>
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<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>
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<term>Adulte d'âge moyen</term>
<term>Charge virale</term>
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<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>
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<ISSN IssnType="Electronic">1728-7731</ISSN>
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<Volume>84</Volume>
<Issue>2</Issue>
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<Month>02</Month>
<Day>01</Day>
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<Title>Journal of the Chinese Medical Association : JCMA</Title>
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<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>
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<LastName>Chen</LastName>
<ForeName>Po-Liang</ForeName>
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<Affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation>
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<LastName>Hsiao</LastName>
<ForeName>Yi-Han</ForeName>
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<Affiliation>Division of General Chest Medicine, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation>
</AffiliationInfo>
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<LastName>Chuang</LastName>
<ForeName>Chien</ForeName>
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<Affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation>
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<ForeName>Jia-Yih</ForeName>
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<Affiliation>Division of Pulmonary Immunology & Infectious Disease, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation>
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<LastName>Ho</LastName>
<ForeName>Hsiang-Ling</ForeName>
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<Affiliation>Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation>
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<AffiliationInfo>
<Affiliation>Division of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation>
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<AffiliationInfo>
<Affiliation>Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation>
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<AffiliationInfo>
<Affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation>
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<AffiliationInfo>
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<AffiliationInfo>
<Affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation>
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<Affiliation>Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation>
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<AffiliationInfo>
<Affiliation>Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation>
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<ForeName>Yuh-Min</ForeName>
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<AffiliationInfo>
<Affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation>
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<ForeName>Fu-Der</ForeName>
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<AffiliationInfo>
<Affiliation>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.</Affiliation>
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<AffiliationInfo>
<Affiliation>School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.</Affiliation>
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<name sortKey="Huang, Shiang Fen" sort="Huang, Shiang Fen" uniqKey="Huang S" first="Shiang-Fen" last="Huang">Shiang-Fen Huang</name>
<name sortKey="Huang, Shiang Fen" sort="Huang, Shiang Fen" uniqKey="Huang S" first="Shiang-Fen" last="Huang">Shiang-Fen Huang</name>
<name sortKey="Lin, Yi Tsung" sort="Lin, Yi Tsung" uniqKey="Lin Y" first="Yi-Tsung" last="Lin">Yi-Tsung Lin</name>
<name sortKey="Lin, Yi Tsung" sort="Lin, Yi Tsung" uniqKey="Lin Y" first="Yi-Tsung" last="Lin">Yi-Tsung Lin</name>
<name sortKey="Wang, Fu Der" sort="Wang, Fu Der" uniqKey="Wang F" first="Fu-Der" last="Wang">Fu-Der Wang</name>
<name sortKey="Wang, Fu Der" sort="Wang, Fu Der" uniqKey="Wang F" first="Fu-Der" last="Wang">Fu-Der Wang</name>
</country>
</tree>
</affiliations>
</record>

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