Do we Trust the Polymerase Chain Reaction Test Result in Children to Diagnose COVID-19? A Case Report of COVID-19
BACKGROUND: Coronavirus disease-19 (COVID-19) resulted in widespread concern in global public health and has a bad prognosis despite drug therapy.
CASE REPORT: The patient was an 11-year-old girl referred to a children hospital with a dry cough, fever, and headache symptoms, without comorbidity. She was hospitalized following the results of high-resolution computed tomography (HRCT). The patient was treated with ceftriaxone 1 g every 12 h and the oseltamivir capsule 45 mg every 12 h and azithromycin 250 mg tablet once daily and 200 mg hydroxychloroquine tablet every 12 h for a total of 5 days. After 5 days, the patient had suitable chest status and then was discharged. Azithromycin for 5 days and hydroxychloroquine for 10 days were prescribed for the patient to take at home. The patient’s polymerase chain reaction (PCR) was negative at baseline through the nasopharyngeal swap, but HRCT of the patient’s was completely consistent with COVID-19 accompanied by consolidation and ground-glass opacity in the left lower and right upper lobes.
CONCLUSION: The numerous technical errors in taking the nasopharyngeal swap were the main reasons for the negative PCR. The main lesson from this case report is the high sensitivity and specificity of HRCT compared to the PCR.
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Dadashzadeh N, Farshid S, Valizadeh R, Nanbakhsh M, Rahimi MM. Acute respiratory distress syndrome in COVID-19 disease. Immunopathol Persa. 2020;6(2):e16.
Valizadeh R, Dadashzadeh N, Zakeri R, Kelllner SJ, Rahimi MM. Drug therapy in hospitalized patients with very severe symptoms following COVID-19. J Nephropharmacol. 2020;9(2):e21.
Valizadeh R, Baradaran A, Mirzazadeh A, Bhaskar LV. Coronavirus-nephropathy; renal involvement in COVID-19. J Renal Inj Prev. 2020;9(2):e18. https://doi.org/10.34172/jrip.2020.18
Mubarak M, Nasri N. COVID-19 nephropathy; an emerging condition caused by novel coronavirus infection. J Nephropathol. 2020;9(3):e21. https://doi.org/10.34172/jnp.2020.21
Bogoch II, Watts A, Thomas-Bachli A, Huber C, Kraemer MU, Khan K. Pneumonia of unknown etiology in Wuhan, China: Potential for international spreadvia commercial air travel. J Trav Med. 2020;27(2):taaa008. https://doi.org/10.1093/jtm/taaa008PMid:31943059
Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan China: The mystery and the miracle. J Med Virol. 2020;92(4):401-2. https://doi.org/10.1002/jmv.25678PMid:31950516
Zhao S, Lin Q, Ran J, Musa SS, Yang G, Wang W, et al. Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak. Int J Infect Dis. 2020;92:214-7. https://doi.org/10.1101/2020.01.23.916395PMid:32007643
Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. J Med Virol. 2020;92(4):441-7. https://doi.org/10.1002/jmv.25689
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199-207. PMid:31995857
Forouzesh M, Azadeh R, Valizadeh R, Dadashzadeh N, Mirzazadeh A. Clinical display, diagnostics and genetic implication of novel coronavirus (COVID-19). Eur Rev Med Pharmacol Sci. 2020;24(8):4607-15. PMid:32374001
Emery SL, Erdman DD, Bowen MD, Newton BR, Winchell JM, Meyer RF, et al. Real-time reverse transcription-polymerase chain reaction assay for SARS-associated coronavirus. Emerg Infect Dis. 2004;10(2):311-6. https://doi.org/10.3201/eid1002.030759PMid:15030703
Gaunt ER, Hardie A, Claas EC, Simmonds P, Templeton KE. Epidemiology and clinical presentations of the four human coronaviruses 229E, HKU1, NL63, and OC43 detected over 3 years using a novel multiplex real-time PCR method. J Clin Microbiol. 2010;48(8):2940-7. https://doi.org/10.1128/jcm.00636-10 PMid:20554810
Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: An observational cohort study. Lancet Infect Dis. 2020;20(6):689-96. https://doi.org/10.1016/s1473-3099(20)30198-5
Le HT, Nguyen LV, Tran DM, Do HT, Tran HT, Le YT, et al. The first infant case of COVID-19 acquired from a secondary transmission in Vietnam. Lancet Child Adolesc Health. 2020;4(5):405-6. https://doi.org/10.1016/s2352-4642(20)30091-2 PMid:32213326
Liu W, Zhang Q, Chen J, Xiang R, Song H, Shu S, et al. Detection of Covid-19 in children in early January 2020 in Wuhan, China. N Engl J Med. 2020;382(14):1370-1. https://doi.org/10.1056/nejmc2003717 PMid:32163697
Jahromi AH, Mazloom S, Ballard DH. What the European and American health care systems can learn from China COVID-19 epidemic; action planning using purpose designed medical telecommunication, courier services, home-based quarantine, and COVID-19 walk-in centers. Immunopathol Persa. 2020;6(2):e17. https://doi.org/10.1016/j.tmaid.2020.101676
Ghelichi-Ghojogh M, Kalteh EA, Fararooei M. Coronavirus disease 2019; epidemiology and recommendations. J Prev Epidemiol. 2020;5(1):e01.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. https://doi.org/10.1016/s0140-6736(20)30183-5 PMid:31986264
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