The novel coronavirus (COVID-19) pneumonia with negative detection of viral ribonucleic acid from nasopharyngeal swabs: a case report

• Main Authors: Peiyan Zhang, Zhao Cai, Weibo Wu, Ling Peng, Yinfeng Li, Chuming Chen, Li Chen, Jianming Li, Mengli Cao, Shiyan Feng, Xiao Jiang, Jing Yuan, Yingxia Liu, Liang Yang, Fuxiang Wang
• Format: Article
• Language: English
• Published: BMC 2020-04-01
• Series: BMC Infectious Diseases
• Subjects: Coronavirus; COVID-19; Pneumonia; Tracheoscopy; Bronchoalveolar-lavage fluid
• Online Access: http://link.springer.com/article/10.1186/s12879-020-05045-z

Abstract Background The novel coronavirus disease 2019 (COVID-19) outbreak started in Wuhan, Hubei, China since Dec 2019 and cases of infection have been continuously reported in various countries. It is now clear that the SARS-COV-2 coronavirus is transmissible from human to human. Nucleic acid detection is considered as the gold standard for the diagnosis of COVID-19. In this case report, we describe our experience in detection of SARS-COV-2 from a confirmed patient using nucleic acid test of bronchoalveolar-lavage fluid (BALF) samples but not nasopharyngeal swabs. Case presentation We present a case of severely ill SARS-COV-2 infected 46-year-old man with fever, coughing and chest tightness. We performed viral detection using his BALF samples and imaging method (CT) for confirmation. The patient received combination of interferonalfa-1b and ribavirin, lopinavir and ritonavir for antiviral treatment at different stages. Other medication was also given to him in combination for anti-inflammation, intestinal microbial regulation, phlegm elimination, liver protection and pulmonary fibrosis prevention purposes. We provided oxygen supply to him using BIPAP ventilator and high-flow humidification oxygen therapy instrument to facilitate respiration. The patient was cured and discharged. Conclusion This case report described an effective supportive medication scheme to treat SARS-COV-2 infected patient and emphasized the necessity of detection of the viral genome using BALF samples and its significance in the diagnosis and prognosis of the disease.