The presence of SARS-CoV-2 in multiple clinical specimens of a fatal case of COVID-19: a case report

Journal of Medical Case Reports

Case Report

Anda Vilmane¹  Liba Sokolovska¹  Anna Terentjeva-Decuka¹  Zaiga Nora-Krukle¹  Modra Murovska¹  Sabine Gravelsina¹  Katrine Vecvagare¹  Maksims Cistjakovs¹ 

[1] Institute of Microbiology and Virology, Riga Stradins University, 1067, Riga, Latvia;

关键词: SARS-CoV-2;    COVID-19;    Severe disease;    Lymphoma;    Viremia;    PBMC;   

DOI  :  10.1186/s13256-022-03706-y

 received in 2021-07-28, accepted in 2022-12-02,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThe risk of developing severe and even fatal coronavirus disease 2019 (COVID-19) increases with various factors such as advanced age and chronic diseases, especially those treated with immunosuppressive drugs. Viral ribonucleic acid (RNA) and viral load detection in extra-pulmonary specimens have been proposed to indicate disease severity.Case presentationHere we describe a fatal COVID-19 case of an 83-year-old Caucasian male patient with various underlying comorbidities, including cardiovascular and autoimmune disorders, as well as immunosuppression due to lymphoma treatment. Upon admission, the patient was radiologically diagnosed with severe COVID-19. The patient was febrile and presented with diarrhea, continued dyspnea, tachypnea, and low blood oxygen saturation, treated with high-concentration oxygen supplementation and antibacterial therapy. Overall the patient was treated for COVID-19 for 19 days. Blood tests were performed upon admission, on the fifth, 10th, 13th, and 19th day. In addition, nasopharyngeal swab, blood, urine, and fecal samples were collected from the patient on the 14th day for virological and immunological investigations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detectable in all samples collected from this patient, including blood plasma and peripheral blood mononuclear cells (PBMC), with very high viral loads. However, neither virus-specific IgA, IgM, nor IgG antibodies were detectable.ConclusionsThe various cardiovascular, autoimmune, and oncological disorders, advanced age, and the high levels of inflammatory markers predisposed the patient to severe COVID-19 and determined the fatal outcome of the disease. We believe that the multiple specimen SARS-CoV-2 positivity and extremely high viral loads in nasopharyngeal swab and fecal samples to be the result of COVID-19 severity, the inability of viral clearance and weakened immune response due to advanced age, comorbidities, and the presence of non-Hodgkin's lymphoma and the immunosuppressive treatment for it, highlighting the risks of COVID-19 in such patients.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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