case_images: PMC7332546_01
case_images: RT-qPCR of SARS-CoV-2 nucleic acid with patient throat swab and sputum specimens on Feb 8 (A), Feb 9 (B), Feb 12 (C), Feb 13 (D), Feb 14 (E), Feb 19 (F). Two target genes of SARS-CoV-2 including open reading frame 1ab (ORF1ab) and Nucleocapsid protein (N) marked as FAM and VIC channel, respectively, are simultaneously tested to report a positive gene. Human GAPDH indicates a reference gene. Ct value were demonstrated on the diagram.
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case_images: PMC7332546_01_fpubh-08-00339-g0001.jpg
case_images: F1
case_images: The two consecutive RT-qPCR tests from mixed samples were both negative on February 8 and 9, respectively (Figures 1A,B). Ct values of 39.05 and 36.45, for Nucleocapsid protein (N) and open reading frame 1ab (ORF1ab) genes, respectively (Figure 1C). Combining with 6 L/min of oxygen absorption by mask and 98% of pulse oxygen, the patient was diagnosed as COVID-19 state and was subsequently treated with antiviral drugs including interferon atomization, lopinavir, abidol, ribavirin, and anti-inflammatory medications like methylprednisolone sodiumsuccinate. The negative RT-qPCR tests also showed on February 13 and 14 (Figures 1D,E). From February 18, the patient symptoms improved and she maintained a normal body temperature, and the viral RNA detection remained negative (Figure 1F).
case_images: Chest CT imaging of the patient on Feb 10 -Feb 19, 2020. (A-C) pulmonary trunk as the reference coordinate, (D-F) tracheal bifurcation as the reference coordinate. CT, computed tomography. Red circle indicates the focus of lesion.
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case_images: PMC7332546_01_fpubh-08-00339-g0002.jpg
case_images: F2
case_images: Chest CT results showed aggravating lesions of bilateral pneumonia on February 10, with a little pleural effusion (Figures 2A,D, red coil). The chest CT scan on February 14 indicated partial absorption of pneumonia lesions than before (Figures 2B,E). The obvious absorption and improvements were observed on the CT imaging on February 19 (Figures 2C,F).
case_images: Anti-SARS-CoV-2 specific IgA, IgM and IgG levels in COVID-19 patient serum from the 17th to the 128th day after onset of illness. (A) Spike RBD-specific antibodies. (B) Nucleocapsid-specific antibodies. The values of RLU (relative light units) converted COI (Cut-Off Index) were indicated for three antibodies with red, green, and blue, respectively. Serological test results of the patient family members on June 2 in a follow-up visit with spike RBD-specific antibodies (C) and nucleocapsid-specific antibodies (D). COI > 1 indicates positive results, and COI < 1 indicates negative results.
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case_images: PMC7332546_01_fpubh-08-00339-g0003.jpg
case_images: F3
case_images: Serological testing of five antibodies showed positive results (Cut-Off Index or COI > 1), which confirming SARS-CoV-2 infection (Figures 3A,B). SARS-CoV-2 (Figures 3C,D). SARS-CoV-2 RNA tests from throat swab samples in her family members were also negative.