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Case of the Index Patient Who Caused Tertiary Transmission of Coronavirus Disease 2019 in Korea: the Application of Lopinavir/Ritonavir for the Treatment of COVID-19 Pneumonia Monitored by Quantitative RT-PCR

Identifieur interne : 000634 ( Pmc/Curation ); précédent : 000633; suivant : 000635

Case of the Index Patient Who Caused Tertiary Transmission of Coronavirus Disease 2019 in Korea: the Application of Lopinavir/Ritonavir for the Treatment of COVID-19 Pneumonia Monitored by Quantitative RT-PCR

Auteurs : Jaegyun Lim [Corée du Sud] ; Seunghyun Jeon [Corée du Sud] ; Hyun-Young Shin [Corée du Sud] ; Moon Jung Kim [Corée du Sud] ; Yu Min Seong [Corée du Sud] ; Wang Jun Lee [Corée du Sud] ; Kang-Won Choe [Corée du Sud] ; Yu Min Kang [Corée du Sud] ; Baeckseung Lee [Corée du Sud] ; Sang-Joon Park [Corée du Sud]

Source :

RBID : PMC:7025910

Abstract

Since mid-December of 2019, coronavirus disease 2019 (COVID-19) has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.


Url:
DOI: 10.3346/jkms.2020.35.e79
PubMed: 32056407
PubMed Central: 7025910

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PMC:7025910

Le document en format XML

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<surname>Lim</surname>
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<surname>Jeon</surname>
<given-names>Seunghyun</given-names>
</name>
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<contrib-id contrib-id-type="orcid" authenticated="true">https://orcid.org/0000-0001-7261-3365</contrib-id>
<name>
<surname>Shin</surname>
<given-names>Hyun-Young</given-names>
</name>
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<contrib contrib-type="author">
<contrib-id contrib-id-type="orcid" authenticated="true">https://orcid.org/0000-0003-4148-9116</contrib-id>
<name>
<surname>Kim</surname>
<given-names>Moon Jung</given-names>
</name>
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<contrib contrib-type="author">
<contrib-id contrib-id-type="orcid" authenticated="true">https://orcid.org/0000-0001-9650-6353</contrib-id>
<name>
<surname>Seong</surname>
<given-names>Yu Min</given-names>
</name>
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</contrib>
<contrib contrib-type="author">
<contrib-id contrib-id-type="orcid" authenticated="true">https://orcid.org/0000-0002-3042-1557</contrib-id>
<name>
<surname>Lee</surname>
<given-names>Wang Jun</given-names>
</name>
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<contrib contrib-type="author">
<contrib-id contrib-id-type="orcid" authenticated="true">https://orcid.org/0000-0003-2003-6492</contrib-id>
<name>
<surname>Choe</surname>
<given-names>Kang-Won</given-names>
</name>
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<contrib contrib-type="author">
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<name>
<surname>Kang</surname>
<given-names>Yu Min</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
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<contrib contrib-type="author" corresp="yes">
<contrib-id contrib-id-type="orcid" authenticated="true">https://orcid.org/0000-0001-7867-8434</contrib-id>
<name>
<surname>Lee</surname>
<given-names>Baeckseung</given-names>
</name>
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<name>
<surname>Park</surname>
<given-names>Sang-Joon</given-names>
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<aff id="A1">
<label>1</label>
Department of Laboratory Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang,
<country>Korea</country>
.</aff>
<aff id="A2">
<label>2</label>
New Horizon Cancer Institute, Myongji Hospital, Goyang,
<country>Korea</country>
.</aff>
<aff id="A3">
<label>3</label>
Department of Family Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang,
<country>Korea</country>
.</aff>
<aff id="A4">
<label>4</label>
Department of Internal Medicine, Myongji Hospital, Goyang,
<country>Korea</country>
.</aff>
<aff id="A5">
<label>5</label>
Office of Chief Executive Officer and Chairman, Department of General Surgery, Myongji Hospital, Goyang,
<country>Korea</country>
.</aff>
<aff id="A6">
<label>6</label>
Department of Infectious Diseases, Myongji Hospital, Goyang,
<country>Korea</country>
.</aff>
<aff id="A7">
<label>7</label>
CancerROP, Seoul,
<country>Korea</country>
.</aff>
<aff id="A8">
<label>8</label>
Department of Pulmonary and Critical Care Medicine, Myongji Hospital, Goyang,
<country>Korea</country>
.</aff>
<author-notes>
<corresp>Address for Correspondence: Sang-Joon Park, MD, PhD. Department of Pulmonary and Critical Care Medicine, Myongji Hospital, 55 Hwasu-ro 14-beon-gil, Deogyang-gu, Goyang 10475, Republic of Korea.
<email>drjoseph@mjh.or.kr</email>
</corresp>
<corresp>Address for Correspondence: Baeckseung Lee, PhD. CancerROP, 173 Digital-ro, Geumcheon-gu, Seoul 08511, Republic of Korea.
<email>baeckseung@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>14</day>
<month>2</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="collection">
<day>17</day>
<month>2</month>
<year>2020</year>
</pub-date>
<volume>35</volume>
<issue>6</issue>
<elocation-id>e79</elocation-id>
<history>
<date date-type="received">
<day>10</day>
<month>2</month>
<year>2020</year>
</date>
<date date-type="accepted">
<day>11</day>
<month>2</month>
<year>2020</year>
</date>
</history>
<permissions>
<copyright-statement>© 2020 The Korean Academy of Medical Sciences.</copyright-statement>
<copyright-year>2020</copyright-year>
<copyright-holder>The Korean Academy of Medical Sciences</copyright-holder>
<license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by-nc/4.0/">
<license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (
<ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by-nc/4.0/">https://creativecommons.org/licenses/by-nc/4.0/</ext-link>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<p>Since mid-December of 2019, coronavirus disease 2019 (COVID-19) has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.</p>
</abstract>
<abstract abstract-type="graphical">
<title>Graphical Abstract</title>
<p>
<graphic xlink:href="jkms-35-e79-abf001.jpg" position="float" orientation="portrait"></graphic>
</p>
</abstract>
<kwd-group kwd-group-type="author">
<kwd>Coronavirus</kwd>
<kwd>COVID-19</kwd>
<kwd>Pneumonia</kwd>
<kwd>Tertiary Infection</kwd>
<kwd>Viral Load</kwd>
<kwd>Real-Time Reverse-Transcriptase Polymerase Chain Reaction</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group>
<fig id="F1" fig-type="figure" orientation="portrait" position="float">
<label>Fig. 1</label>
<caption>
<title>Radiologic findings of the patient.</title>
<p>(
<bold>A</bold>
) Chest X-ray of illness day 3, hospital day 1. (
<bold>B</bold>
) Chest X-ray of illness day 9, hospital day 7. (
<bold>C</bold>
) Chest X-ray of illness day 15, hospital day 13. (
<bold>D</bold>
) HRCT scan of illness day 9, hospital day 7. (
<bold>E</bold>
) HRCT scan of illness day 15, hospital day 13.</p>
<p>AP(P) = Anteroposterior (Portable X-ray), HRCT = high-resolution computed tomography.</p>
</caption>
<graphic xlink:href="jkms-35-e79-g001"></graphic>
</fig>
<fig id="F2" fig-type="figure" orientation="portrait" position="float">
<label>Fig. 2</label>
<caption>
<title>Clinical course, treatment and viral load of the patient.</title>
<p>RdRP = RNA-dependent RNA polymerase, Posi = positive, Nega = negative, UD = undeteced, Ct = cycle threshold.</p>
</caption>
<graphic xlink:href="jkms-35-e79-g002"></graphic>
</fig>
<table-wrap id="T1" orientation="portrait" position="float">
<label>Table 1</label>
<caption>
<title>Serial laboratory results of the patient</title>
</caption>
<alternatives>
<graphic xlink:href="jkms-35-e79-i001"></graphic>
<table frame="hsides" rules="rows">
<col width="24.19%" span="1"></col>
<col width="9.48%" span="1"></col>
<col width="9.48%" span="1"></col>
<col width="9.48%" span="1"></col>
<col width="9.48%" span="1"></col>
<col width="9.48%" span="1"></col>
<col width="9.48%" span="1"></col>
<col width="9.48%" span="1"></col>
<col width="9.48%" span="1"></col>
<thead>
<tr>
<th valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(211,212,235)">Variables</th>
<th valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(211,212,235)">Illness day 3 (HD 1)</th>
<th valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(211,212,235)">Illness day 6 (HD 4)</th>
<th valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(211,212,235)">Illness day 7 (HD 5)</th>
<th valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(211,212,235)">Illness day 8 (HD 6)</th>
<th valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(211,212,235)">Illness day 10 (HD 8)</th>
<th valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(211,212,235)">Illness day 12 (HD 10)</th>
<th valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(211,212,235)">Illness day 14 (HD 12)</th>
<th valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(211,212,235)">Illness day 16 (HD 14)</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">White blood cell count, ×10
<sup>3</sup>
/µL</td>
<td valign="top" align="center" rowspan="1" colspan="1">7,200</td>
<td valign="top" align="center" rowspan="1" colspan="1">5,800</td>
<td valign="top" align="center" rowspan="1" colspan="1">5,200</td>
<td valign="top" align="center" rowspan="1" colspan="1">6,700</td>
<td valign="top" align="center" rowspan="1" colspan="1">6,000</td>
<td valign="top" align="center" rowspan="1" colspan="1">6,700</td>
<td valign="top" align="center" rowspan="1" colspan="1">8,600</td>
<td valign="top" align="center" rowspan="1" colspan="1">9,100</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">Segment neutrophil, %</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">59.0</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">64.2</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">50.3</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">69.3</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">58.8</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">55.5</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">63.1</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">63.0</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Lymphocyte, %</td>
<td valign="top" align="center" rowspan="1" colspan="1">28.5</td>
<td valign="top" align="center" rowspan="1" colspan="1">24.0</td>
<td valign="top" align="center" rowspan="1" colspan="1">36.5</td>
<td valign="top" align="center" rowspan="1" colspan="1">19.1</td>
<td valign="top" align="center" rowspan="1" colspan="1">30.9</td>
<td valign="top" align="center" rowspan="1" colspan="1">29.4</td>
<td valign="top" align="center" rowspan="1" colspan="1">24.4</td>
<td valign="top" align="center" rowspan="1" colspan="1">24.9</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">Monocyte, %</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">11.5</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">11.0</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">11.6</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">10.7</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">9.2</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">13.5</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">10.9</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">10.2</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Eosinophil, %</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.6</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.3</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.0</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.6</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.8</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.3</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.3</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.5</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">Hemoglobin, g/dL</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">16.3</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">15.4</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">16.1</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">15.3</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">15.2</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">14.9</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">14.2</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">13.9</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Platelets, ×10
<sup>3</sup>
/µL</td>
<td valign="top" align="center" rowspan="1" colspan="1">301</td>
<td valign="top" align="center" rowspan="1" colspan="1">176</td>
<td valign="top" align="center" rowspan="1" colspan="1">212</td>
<td valign="top" align="center" rowspan="1" colspan="1">225</td>
<td valign="top" align="center" rowspan="1" colspan="1">229</td>
<td valign="top" align="center" rowspan="1" colspan="1">287</td>
<td valign="top" align="center" rowspan="1" colspan="1">358</td>
<td valign="top" align="center" rowspan="1" colspan="1">507</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">Glucose, mg/dL</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">97</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">114</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">103</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">BUN, mg/dL</td>
<td valign="top" align="center" rowspan="1" colspan="1">13.0</td>
<td valign="top" align="center" rowspan="1" colspan="1">7.0</td>
<td valign="top" align="center" rowspan="1" colspan="1">10.1</td>
<td valign="top" align="center" rowspan="1" colspan="1">9.1</td>
<td valign="top" align="center" rowspan="1" colspan="1">9.6</td>
<td valign="top" align="center" rowspan="1" colspan="1">7.9</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.3</td>
<td valign="top" align="center" rowspan="1" colspan="1">8.1</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">Creatinine, mg/dL</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">1.0</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">0.8</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">1.2</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">0.8</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">1.0</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">0.8</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">0.8</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">0.9</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Total bilirubin, mg/dL</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.50</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.47</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.35</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.61</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.74</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.85</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.09</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">AST, U/L</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">27</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">31</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">22</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">127</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">54</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">19</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">17</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">ALT, U/L</td>
<td valign="top" align="center" rowspan="1" colspan="1">29</td>
<td valign="top" align="center" rowspan="1" colspan="1">37</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">29</td>
<td valign="top" align="center" rowspan="1" colspan="1">106</td>
<td valign="top" align="center" rowspan="1" colspan="1">83</td>
<td valign="top" align="center" rowspan="1" colspan="1">45</td>
<td valign="top" align="center" rowspan="1" colspan="1">30</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">Uric acid, mg/dL</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">8.6</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">7.0</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">CK, U/L</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">43</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">31</td>
<td valign="top" align="center" rowspan="1" colspan="1">30</td>
<td valign="top" align="center" rowspan="1" colspan="1">28</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">ALP, U/L</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">62</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">140</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">113</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">95</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">LDH, U/L</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">332</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">351</td>
<td valign="top" align="center" rowspan="1" colspan="1">329</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">Sodium, mmol/L</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">138</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">135</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">138</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">137</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">138</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">138</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">138</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">139</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Potassium, mmol/L</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.3</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.1</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.8</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.2</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.2</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.3</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.2</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.3</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">Chloride, mmol/L</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">104</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">104</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">105</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">104</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">102</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">103</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">103</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">103</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Total protein, g/dL</td>
<td valign="top" align="center" rowspan="1" colspan="1">7.4</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.4</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.8</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.3</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.3</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.4</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.3</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.5</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">Albumin, g/dL</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">4.5</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">3.9</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">4.1</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">3.8</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">3.8</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">3.8</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">3.7</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">3.7</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">ESR, mm/hr</td>
<td valign="top" align="center" rowspan="1" colspan="1">26</td>
<td valign="top" align="center" rowspan="1" colspan="1">27</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">66</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">82</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">CRP, mg/dL</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">0.43</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">1.23</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">4.51</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">10.94</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">9.11</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">11.20</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">3.60</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Pro-Calcitonin, ng/mL</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.06</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">PT, sec</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">12.5</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">12.9</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">13.2</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">13.1</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">13.6</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">13.6</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">PT INR</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.96</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.00</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.03</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.02</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.07</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.07</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">aPTT, sec</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">40.4</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">38.5</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">-</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">38.8</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">38.0</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">40.1</td>
<td valign="top" align="center" rowspan="1" colspan="1" style="background-color:rgb(224,224,241)">40.7</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">D-dimer, µg/mL (FEU)</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.28</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.22</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<p>HD = hospital day, AST = aspartate aminotransferase, ALT = alanine aminotransferase, CK = creatine kinase, ALP = alkaline phosphatase, LDH = lactate dehydrogenase, ESR = erythrocyte sedimentation rate, CRP = C-reactive protein, PT = prothrombin time, INR = international normalized ratio, aPTT = activated partial thromboplastin time, FEU = fibrinogen equivalent units.</p>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
</record>

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