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. 2020 Jun;53(3):459-466.
doi: 10.1016/j.jmii.2020.03.008. Epub 2020 Mar 13.

Featuring COVID-19 cases via screening symptomatic patients with epidemiologic link during flu season in a medical center of central Taiwan

Wen-Hsin Hsih  1 , Meng-Yu Cheng  2 , Mao-Wang Ho  3 , Chia-Huei Chou  3 , Po-Chang Lin  3 , Chih-Yu Chi  3 , Wei-Chih Liao  4 , Chih-Yu Chen  4 , Lih-Ying Leong  3 , Ni Tien  5 , Huan-Cheng Lai  6 , Yi-Chyi Lai  7 , Min-Chi Lu  8
Affiliations

Featuring COVID-19 cases via screening symptomatic patients with epidemiologic link during flu season in a medical center of central Taiwan

Wen-Hsin Hsih et al. J Microbiol Immunol Infect. 2020 Jun.

Abstract

Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CO-V-2), was first reported in Wuhan, Hubei province, China has now rapidly spread over 50 countries. For the prevention and control of infection, Taiwan Centers for Disease Control initiated testing of SARS-CoV-2 on January 24th 2020 for persons suspected with this disease. Until February 28th, 43 flu-like symptomatic patients were screened in China Medical University Hospital.

Methods: Two patients were confirmed positive for SARS-CoV-2 infection by rRT-PCR as COVID-19 patients A and B. Causative pathogens for included patients were detected using FilmArray™ Respiratory Panel. We retrospectively analyzed the clinical presentations, laboratory data, radiologic findings, and travel and exposure contact histories, of the COVID-19 patients in comparison to those with other respiratory infections.

Results: Through contact with Taiwan No. 19 case patient on 27th January, COVID-19 patients A and B were infected. Both patients had no identified comorbidities and developed mild illness with temporal fever, persistent cough, and lung interstitial infiltrates. Owing to the persistence of positive SARS-CoV-2 in respiratory specimen, the two COVID-19 patients are still in the isolation rooms despite recovery until 10th of March. The results of FilmArrayTM Respiratory Panel revealed 22 of the 41 non-COVID-19 patients were infected by particular pathogens. In general, seasonal respiratory pathogens are more prevalent than SARS-CoV-2 in symptomatic patients in non- COVID-19 endemic area during the flu season. Since all patients shared similar clinical and laboratory findings, expanded surveillance of detailed exposure history for suspected patients and application of rapid detection tools are highly recommended.

Keywords: COVID-19; FilmArray™ Respiratory Panel; SARS-CO-V-2.

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Figures

Fig. 1
Figure 1
Clinical symptoms (A) and SARS-CoV-2 rRT-PCR tests (B) of COVID-19 patient A and B. Upon exposure to Taiwan No. 19 case patient on 27th January, COVID-19 patient A and B developed symptoms on 28th January and 3rd February, respectively. Naso-oropharyngeal or sputum specimens collected from both of them were tested positive for SARS-CoV-2 on three samplings during hospitalization.
Fig. 2
Figure 2
Chest radiographs of COVID-19 patient A (A1 and A2) and patient B (B1 and B2). No active lung lesion was noted in patient A on admission (16th February; illness day 20) (A1), while right upper lung interstitial infiltrates were presented on day 6 on admission (21st February; illness day 25) (A2). Left lower lung interstitial infiltrates were noted in patient B on admission (17th February; illness day 15) (B1) and persisted to day 5 of admission (21st February; illness day 19) (B2).
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