A Case of COVID-19 Failed in Viral Identification but Showed Consistent Host Responses to Severe Acute Respiratory Syndrome Coronavirus 2

Yoshitaka Maeda; Hiroyuki Miyo; Atsuki Ohashi; Takanobu Yamamoto; Tomoyuki Ogata

doi:10.14740/jmc3566

A Case of COVID-19 Failed in Viral Identification but Showed Consistent Host Responses to Severe Acute Respiratory Syndrome Coronavirus 2

J Med Cases. 2020 Oct;11(10):330-335. doi: 10.14740/jmc3566. Epub 2020 Aug 28.

Authors

Yoshitaka Maeda¹, Hiroyuki Miyo², Atsuki Ohashi^{1

2}, Takanobu Yamamoto², Tomoyuki Ogata²

Affiliations

¹ Nephrology Division, Department of Internal Medicine, JA Toride Medical Center, Toride, Ibaraki 302-0022, Japan.
² Infection Control Team, Department of Internal Medicine, JA Toride Medical Center, Toride, Ibaraki 302-0022, Japan.

Abstract

In a 75-year-old hemodialysis patient, pneumonia manifested with computed tomography (CT) images suggestive of coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid (RNA) was not detected with repeated polymerase chain reaction (PCR) tests, but serum immunoglobulin G (IgG) and IgM antibodies against SARS-CoV-2 turned positive with two different assay kits. The patient was thus treated as a probable COVID-19 case, and then recovered through the intensive care including ciclesonide, favipiravir, and methyl prednisolone. In PCR-negative cases, the diagnosis of COVID-19 cannot be established at present, but such COVID-19 cases certainly exist. To avoid a delay in treatment of COVID-19, available diagnostic tools should be utilized with careful attention for their limitations.

Keywords: Ciclesonide; ESKD; Favipiravir; SARS-CoV-2.

Publication types

Case Reports