Characteristics and Unexpected COVID-19 Diagnoses in Resuscitation Room Patients during the COVID-19 Outbreak-A Retrospective Case Series.
Identifieur interne : 000808 ( Main/Exploration ); précédent : 000807; suivant : 000809Characteristics and Unexpected COVID-19 Diagnoses in Resuscitation Room Patients during the COVID-19 Outbreak-A Retrospective Case Series.
Auteurs : Sebastian Bergrath [Allemagne] ; Olaf Aretz [Allemagne] ; Hendrik Haake [Allemagne] ; Adrian Ringelstein [Allemagne] ; Ingo Greiffendorf [Allemagne] ; Ullrich Graeven [Allemagne] ; Jochen Windfuhr [Allemagne]Source :
- BioMed research international [ 2314-6141 ] ; 2020.
Descripteurs français
- KwdFr :
- ARN viral (génétique), ARN viral (isolement et purification), Adulte d'âge moyen (MeSH), Allemagne (épidémiologie), Betacoronavirus (MeSH), Diagnostic différentiel (MeSH), Faux négatifs (MeSH), Femelle (MeSH), Humains (MeSH), Infections à coronavirus (diagnostic), Infections à coronavirus (imagerie diagnostique), Infections à coronavirus (épidémiologie), Maladie grave (MeSH), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (diagnostic), Pneumopathie virale (imagerie diagnostique), Pneumopathie virale (épidémiologie), Réaction de polymérisation en chaine en temps réel (MeSH), Réanimation (MeSH), Service hospitalier d'urgences (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Techniques de laboratoire clinique (méthodes), Tomodensitométrie (MeSH), Triage (MeSH), Épidémies de maladies (MeSH), Études rétrospectives (MeSH).
- MESH :
- diagnostic : Infections à coronavirus, Pneumopathie virale.
- génétique : ARN viral.
- imagerie diagnostique : Infections à coronavirus, Pneumopathie virale.
- isolement et purification : ARN viral.
- méthodes : Techniques de laboratoire clinique.
- épidémiologie : Allemagne, Infections à coronavirus, Pneumopathie virale.
- Adulte d'âge moyen, Betacoronavirus, Diagnostic différentiel, Faux négatifs, Femelle, Humains, Maladie grave, Mâle, Pandémies, Réaction de polymérisation en chaine en temps réel, Réanimation, Service hospitalier d'urgences, Sujet âgé, Sujet âgé de 80 ans ou plus, Tomodensitométrie, Triage, Épidémies de maladies, Études rétrospectives.
- Wicri :
- geographic : Allemagne.
English descriptors
- KwdEn :
- Aged (MeSH), Aged, 80 and over (MeSH), Betacoronavirus (MeSH), Clinical Laboratory Techniques (methods), Coronavirus Infections (diagnosis), Coronavirus Infections (diagnostic imaging), Coronavirus Infections (epidemiology), Critical Illness (MeSH), Diagnosis, Differential (MeSH), Disease Outbreaks (MeSH), Emergency Service, Hospital (MeSH), False Negative Reactions (MeSH), Female (MeSH), Germany (epidemiology), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (diagnosis), Pneumonia, Viral (diagnostic imaging), Pneumonia, Viral (epidemiology), RNA, Viral (genetics), RNA, Viral (isolation & purification), Real-Time Polymerase Chain Reaction (MeSH), Resuscitation (MeSH), Retrospective Studies (MeSH), Tomography, X-Ray Computed (MeSH), Triage (MeSH).
- MESH :
- chemical , genetics : RNA, Viral.
- geographic , epidemiology : Germany.
- diagnosis : Coronavirus Infections, Pneumonia, Viral.
- diagnostic imaging : Coronavirus Infections, Pneumonia, Viral.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- chemical , isolation & purification : RNA, Viral.
- methods : Clinical Laboratory Techniques.
- Aged, Aged, 80 and over, Betacoronavirus, Critical Illness, Diagnosis, Differential, Disease Outbreaks, Emergency Service, Hospital, False Negative Reactions, Female, Humans, Male, Middle Aged, Pandemics, Real-Time Polymerase Chain Reaction, Resuscitation, Retrospective Studies, Tomography, X-Ray Computed, Triage.
Abstract
Introduction
Emergency department (ED) triage regarding infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is challenging. During the coronavirus disease 2019 (COVID-19) outbreak in Germany, the diagnostic outcomes of critically ill patients admitted to the resuscitation room in the ED of our academic 754-bed hospital should be analyzed.
Methods
All resuscitation room patients between March 1st and April 15th 2020 were included in this retrospective study. Every patient with suspicion of SARS-CoV-2 infection received a pharyngeal swab for real-time polymerase chain reaction (rt-PCR), divided in the clinical subgroups of "highly suspicious for COVID-19" and "COVID-19 as differential diagnosis." All respiratory and infectious symptoms were included as at least "differential diagnosis" as an expanded suspicion strategy.
Results
Ninety-five patients were included (trauma
Conclusion
We recommend an expanded suspicion strategy for COVID-19 due to unexpected diagnostic outcomes. Personal protective equipment should be used in every resuscitation room operation due to unexpected cases and initial knowledge gaps. Furthermore, tracheal fluid should be tested for SARS-CoV-2 in every intubated patient due to cases with negative pharyngeal swabs and negative chest CT.
DOI: 10.1155/2020/2721381
PubMed: 32884938
PubMed Central: PMC7455815
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Zentrum für klinische Akut-und Notfallmedizin, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach</wicri:regionArea><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>Lehrstuhl für Anästhesiologie, Medizinische Fakultät der RWTH, Aachen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Lehrstuhl für Anästhesiologie, Medizinische Fakultät der RWTH, Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Aretz, Olaf" sort="Aretz, Olaf" uniqKey="Aretz O" first="Olaf" last="Aretz">Olaf Aretz</name><affiliation wicri:level="1"><nlm:affiliation>Zentrum für klinische Akut-und Notfallmedizin, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Zentrum für klinische Akut-und Notfallmedizin, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach</wicri:regionArea><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion></affiliation></author><author><name sortKey="Haake, Hendrik" sort="Haake, Hendrik" uniqKey="Haake H" first="Hendrik" last="Haake">Hendrik Haake</name><affiliation wicri:level="1"><nlm:affiliation>Klinik für Kardiologie und Internistische Intensivmedizin, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Klinik für Kardiologie und Internistische Intensivmedizin, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach</wicri:regionArea><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion></affiliation></author><author><name sortKey="Ringelstein, Adrian" sort="Ringelstein, Adrian" uniqKey="Ringelstein A" first="Adrian" last="Ringelstein">Adrian Ringelstein</name><affiliation wicri:level="1"><nlm:affiliation>Klinik für Radiologie und Neuroradiologie, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Klinik für Radiologie und Neuroradiologie, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach</wicri:regionArea><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion></affiliation></author><author><name sortKey="Greiffendorf, Ingo" sort="Greiffendorf, Ingo" uniqKey="Greiffendorf I" first="Ingo" last="Greiffendorf">Ingo Greiffendorf</name><affiliation wicri:level="1"><nlm:affiliation>Klinik für Hämatologie, Onkologie, Gastroenterologie und Infektiologie, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Klinik für Hämatologie, Onkologie, Gastroenterologie und Infektiologie, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach</wicri:regionArea><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion></affiliation></author><author><name sortKey="Graeven, Ullrich" sort="Graeven, Ullrich" uniqKey="Graeven U" first="Ullrich" last="Graeven">Ullrich Graeven</name><affiliation wicri:level="1"><nlm:affiliation>Klinik für Hämatologie, Onkologie, Gastroenterologie und Infektiologie, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Klinik für Hämatologie, Onkologie, Gastroenterologie und Infektiologie, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach</wicri:regionArea><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion></affiliation></author><author><name sortKey="Windfuhr, Jochen" sort="Windfuhr, Jochen" uniqKey="Windfuhr J" first="Jochen" last="Windfuhr">Jochen Windfuhr</name><affiliation wicri:level="1"><nlm:affiliation>Klinik für Hals-Nasen-Ohrenheilkunde, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Klinik für Hals-Nasen-Ohrenheilkunde, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach</wicri:regionArea><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion><wicri:noRegion>Mönchengladbach</wicri:noRegion></affiliation></author></analytic><series><title level="j">BioMed research international</title><idno type="eISSN">2314-6141</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Betacoronavirus (MeSH)</term><term>Clinical Laboratory Techniques (methods)</term><term>Coronavirus Infections (diagnosis)</term><term>Coronavirus Infections (diagnostic imaging)</term><term>Coronavirus Infections (epidemiology)</term><term>Critical Illness (MeSH)</term><term>Diagnosis, Differential (MeSH)</term><term>Disease Outbreaks (MeSH)</term><term>Emergency Service, Hospital (MeSH)</term><term>False Negative Reactions (MeSH)</term><term>Female (MeSH)</term><term>Germany (epidemiology)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (diagnosis)</term><term>Pneumonia, Viral (diagnostic imaging)</term><term>Pneumonia, Viral (epidemiology)</term><term>RNA, Viral (genetics)</term><term>RNA, Viral (isolation & purification)</term><term>Real-Time Polymerase Chain Reaction (MeSH)</term><term>Resuscitation (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Tomography, X-Ray Computed (MeSH)</term><term>Triage (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>ARN viral (génétique)</term><term>ARN viral (isolement et purification)</term><term>Adulte d'âge moyen (MeSH)</term><term>Allemagne (épidémiologie)</term><term>Betacoronavirus (MeSH)</term><term>Diagnostic différentiel (MeSH)</term><term>Faux négatifs (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Infections à coronavirus (diagnostic)</term><term>Infections à coronavirus (imagerie diagnostique)</term><term>Infections à coronavirus (épidémiologie)</term><term>Maladie grave (MeSH)</term><term>Mâle (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (diagnostic)</term><term>Pneumopathie virale (imagerie diagnostique)</term><term>Pneumopathie virale (épidémiologie)</term><term>Réaction de polymérisation en chaine en temps réel (MeSH)</term><term>Réanimation (MeSH)</term><term>Service hospitalier d'urgences (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Techniques de laboratoire clinique (méthodes)</term><term>Tomodensitométrie (MeSH)</term><term>Triage (MeSH)</term><term>Épidémies de maladies (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="genetics" xml:lang="en"><term>RNA, Viral</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Germany</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="génétique" xml:lang="fr"><term>ARN viral</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" type="chemical" qualifier="isolation & purification" xml:lang="en"><term>RNA, Viral</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>ARN viral</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Clinical Laboratory Techniques</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Techniques de laboratoire clinique</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Allemagne</term><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Betacoronavirus</term><term>Critical Illness</term><term>Diagnosis, Differential</term><term>Disease Outbreaks</term><term>Emergency Service, Hospital</term><term>False Negative Reactions</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Real-Time Polymerase Chain Reaction</term><term>Resuscitation</term><term>Retrospective Studies</term><term>Tomography, X-Ray Computed</term><term>Triage</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Betacoronavirus</term><term>Diagnostic différentiel</term><term>Faux négatifs</term><term>Femelle</term><term>Humains</term><term>Maladie grave</term><term>Mâle</term><term>Pandémies</term><term>Réaction de polymérisation en chaine en temps réel</term><term>Réanimation</term><term>Service hospitalier d'urgences</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tomodensitométrie</term><term>Triage</term><term>Épidémies de maladies</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Allemagne</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Introduction</b></p><p>Emergency department (ED) triage regarding infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is challenging. During the coronavirus disease 2019 (COVID-19) outbreak in Germany, the diagnostic outcomes of critically ill patients admitted to the resuscitation room in the ED of our academic 754-bed hospital should be analyzed.</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>All resuscitation room patients between March 1st and April 15th 2020 were included in this retrospective study. Every patient with suspicion of SARS-CoV-2 infection received a pharyngeal swab for real-time polymerase chain reaction (rt-PCR), divided in the clinical subgroups of "highly suspicious for COVID-19" and "COVID-19 as differential diagnosis." All respiratory and infectious symptoms were included as at least "differential diagnosis" as an expanded suspicion strategy.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>Ninety-five patients were included (trauma </p></div><div type="abstract" xml:lang="en"><p><b>Conclusion</b></p><p>We recommend an expanded suspicion strategy for COVID-19 due to unexpected diagnostic outcomes. Personal protective equipment should be used in every resuscitation room operation due to unexpected cases and initial knowledge gaps. Furthermore, tracheal fluid should be tested for SARS-CoV-2 in every intubated patient due to cases with negative pharyngeal swabs and negative chest CT.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32884938</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>10</Day></DateCompleted><DateRevised><Year>2020</Year><Month>09</Month><Day>10</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">2314-6141</ISSN><JournalIssue CitedMedium="Internet"><Volume>2020</Volume><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>BioMed research international</Title><ISOAbbreviation>Biomed Res Int</ISOAbbreviation></Journal><ArticleTitle>Characteristics and Unexpected COVID-19 Diagnoses in Resuscitation Room Patients during the COVID-19 Outbreak-A Retrospective Case Series.</ArticleTitle><Pagination><MedlinePgn>2721381</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1155/2020/2721381</ELocationID><Abstract><AbstractText Label="Introduction" NlmCategory="UNASSIGNED">Emergency department (ED) triage regarding infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is challenging. During the coronavirus disease 2019 (COVID-19) outbreak in Germany, the diagnostic outcomes of critically ill patients admitted to the resuscitation room in the ED of our academic 754-bed hospital should be analyzed.</AbstractText><AbstractText Label="Methods" NlmCategory="UNASSIGNED">All resuscitation room patients between March 1st and April 15th 2020 were included in this retrospective study. Every patient with suspicion of SARS-CoV-2 infection received a pharyngeal swab for real-time polymerase chain reaction (rt-PCR), divided in the clinical subgroups of "highly suspicious for COVID-19" and "COVID-19 as differential diagnosis." All respiratory and infectious symptoms were included as at least "differential diagnosis" as an expanded suspicion strategy.</AbstractText><AbstractText Label="Results" NlmCategory="UNASSIGNED">Ninety-five patients were included (trauma <i>n</i> = 14, critically ill <i>n</i> = 81). Of 3 highly suspicious patients, 2 had rt-PCR positive pharyngeal swabs. In 39 patients, COVID-19 was defined as differential diagnosis, and 3 were positive for SARS-CoV-2. Of them, pharyngeal swabs were positive in 1 case, while in 2 cases, only tracheal fluid was rt-PCR positive while the pharyngeal swabs were negative. In one of these 2 cases, chest computed tomography (CT) was also negative for ground-glass opacities but showed a pulmonary abscess and pulmonary embolism.</AbstractText><AbstractText Label="Conclusion" NlmCategory="UNASSIGNED">We recommend an expanded suspicion strategy for COVID-19 due to unexpected diagnostic outcomes. Personal protective equipment should be used in every resuscitation room operation due to unexpected cases and initial knowledge gaps. Furthermore, tracheal fluid should be tested for SARS-CoV-2 in every intubated patient due to cases with negative pharyngeal swabs and negative chest CT.</AbstractText><CopyrightInformation>Copyright © 2020 Sebastian Bergrath et al.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Bergrath</LastName><ForeName>Sebastian</ForeName><Initials>S</Initials><Identifier Source="ORCID">https://orcid.org/0000-0001-5297-7655</Identifier><AffiliationInfo><Affiliation>Zentrum für klinische Akut-und Notfallmedizin, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Lehrstuhl für Anästhesiologie, Medizinische Fakultät der RWTH, Aachen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aretz</LastName><ForeName>Olaf</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Zentrum für klinische Akut-und Notfallmedizin, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Haake</LastName><ForeName>Hendrik</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Klinik für Kardiologie und Internistische Intensivmedizin, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ringelstein</LastName><ForeName>Adrian</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Klinik für Radiologie und Neuroradiologie, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Greiffendorf</LastName><ForeName>Ingo</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Klinik für Hämatologie, Onkologie, Gastroenterologie und Infektiologie, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Graeven</LastName><ForeName>Ullrich</ForeName><Initials>U</Initials><AffiliationInfo><Affiliation>Klinik für Hämatologie, Onkologie, Gastroenterologie und Infektiologie, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Windfuhr</LastName><ForeName>Jochen</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Klinik für Hals-Nasen-Ohrenheilkunde, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Biomed Res Int</MedlineTA><NlmUniqueID>101600173</NlmUniqueID></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D012367">RNA, Viral</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Protocol" UI="C000657964">COVID-19 diagnostic testing</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019411" MajorTopicYN="N">Clinical Laboratory Techniques</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016638" MajorTopicYN="N">Critical Illness</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003937" MajorTopicYN="N">Diagnosis, Differential</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004196" MajorTopicYN="N">Disease Outbreaks</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004636" MajorTopicYN="N">Emergency Service, Hospital</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005188" MajorTopicYN="N">False Negative Reactions</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005858" MajorTopicYN="N" Type="Geographic">Germany</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012367" MajorTopicYN="N">RNA, Viral</DescriptorName><QualifierName UI="Q000235" MajorTopicYN="N">genetics</QualifierName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D060888" MajorTopicYN="N">Real-Time Polymerase Chain Reaction</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012151" MajorTopicYN="N">Resuscitation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014057" MajorTopicYN="N">Tomography, X-Ray Computed</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014218" MajorTopicYN="N">Triage</DescriptorName></MeshHeading></MeshHeadingList><CoiStatement>There is no conflict of interest regarding this study reported by any of the authors.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>07</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>07</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId 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