A case of primary COVID-19 pneumonia: plausible airborne transmission of SARS-CoV-2
Abstract Background The different clinical manifestations, from none to severe, and the variability in efficacy of SARS-CoV-2 diagnosis by upper respiratory tract testing, make diagnosis of COVID-19 and prevention of transmission especially challenging. In addition, the ways by which the virus can m...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-022-00668-1 |
| _version_ | 1819209978952548352 |
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| author | Nathan Dumont-Leblond Caroline Duchaine Marc Veillette Visal Pen Marco Bergevin |
| author_facet | Nathan Dumont-Leblond Caroline Duchaine Marc Veillette Visal Pen Marco Bergevin |
| author_sort | Nathan Dumont-Leblond |
| collection | DOAJ |
| description | Abstract Background The different clinical manifestations, from none to severe, and the variability in efficacy of SARS-CoV-2 diagnosis by upper respiratory tract testing, make diagnosis of COVID-19 and prevention of transmission especially challenging. In addition, the ways by which the virus can most efficiently transmit still remain unclear. Case Presentation We report the case a 48-year-old man who presents primary COVID-19 pneumonia. He was initially admitted for cholecystitis but, upon review of his abdominal CT scan, a segmental zone of ground glass opacity was identified in the right lower lobe. A bronchoalveolar lavage proved positive to SARS-CoV-2 by RT-qPCR, even if he tested negative by oro-nasopharyngeal swab at admission and the day after he underwent bronchoscopy. The near absence of the virus in his saliva 2 days after, combined with a very sharp increase in salivary viral load on the third day, also rule out the possibility of prior viral replication in the upper airway and clearance. In addition, rapidly increasing bilateral alveolar lung infiltrates appeared as the upper respiratory tests begin to detect the virus. Conclusions For this patient to have developed primary COVID-19 pneumonia, a contagious aerosol must have traveled to the lower respiratory system. This case gives indirect but compelling evidence that aerosol may spread the virus. It also highlights the limitations of oral and nasal testing methods and the importance of anatomical considerations when studying infections by SARS-CoV-2. |
| first_indexed | 2024-12-23T06:03:53Z |
| format | Article |
| id | doaj.art-31a1fd1d61e448d198725e399976b2c0 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-12-23T06:03:53Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-31a1fd1d61e448d198725e399976b2c02022-12-21T17:57:36ZengBMCEuropean Journal of Medical Research2047-783X2022-04-012711610.1186/s40001-022-00668-1A case of primary COVID-19 pneumonia: plausible airborne transmission of SARS-CoV-2Nathan Dumont-Leblond0Caroline Duchaine1Marc Veillette2Visal Pen3Marco Bergevin4Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de QuébecCentre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de QuébecCentre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de QuébecDepartment of Medical Imaging, Cité-de-La-Santé HospitalDepartment of Microbiology, Cité-de-La-Santé HospitalAbstract Background The different clinical manifestations, from none to severe, and the variability in efficacy of SARS-CoV-2 diagnosis by upper respiratory tract testing, make diagnosis of COVID-19 and prevention of transmission especially challenging. In addition, the ways by which the virus can most efficiently transmit still remain unclear. Case Presentation We report the case a 48-year-old man who presents primary COVID-19 pneumonia. He was initially admitted for cholecystitis but, upon review of his abdominal CT scan, a segmental zone of ground glass opacity was identified in the right lower lobe. A bronchoalveolar lavage proved positive to SARS-CoV-2 by RT-qPCR, even if he tested negative by oro-nasopharyngeal swab at admission and the day after he underwent bronchoscopy. The near absence of the virus in his saliva 2 days after, combined with a very sharp increase in salivary viral load on the third day, also rule out the possibility of prior viral replication in the upper airway and clearance. In addition, rapidly increasing bilateral alveolar lung infiltrates appeared as the upper respiratory tests begin to detect the virus. Conclusions For this patient to have developed primary COVID-19 pneumonia, a contagious aerosol must have traveled to the lower respiratory system. This case gives indirect but compelling evidence that aerosol may spread the virus. It also highlights the limitations of oral and nasal testing methods and the importance of anatomical considerations when studying infections by SARS-CoV-2.https://doi.org/10.1186/s40001-022-00668-1SARS-CoV-2COVID-19Airborne transmissionTestDiagnosisAerosols |
| spellingShingle | Nathan Dumont-Leblond Caroline Duchaine Marc Veillette Visal Pen Marco Bergevin A case of primary COVID-19 pneumonia: plausible airborne transmission of SARS-CoV-2 European Journal of Medical Research SARS-CoV-2 COVID-19 Airborne transmission Test Diagnosis Aerosols |
| title | A case of primary COVID-19 pneumonia: plausible airborne transmission of SARS-CoV-2 |
| title_full | A case of primary COVID-19 pneumonia: plausible airborne transmission of SARS-CoV-2 |
| title_fullStr | A case of primary COVID-19 pneumonia: plausible airborne transmission of SARS-CoV-2 |
| title_full_unstemmed | A case of primary COVID-19 pneumonia: plausible airborne transmission of SARS-CoV-2 |
| title_short | A case of primary COVID-19 pneumonia: plausible airborne transmission of SARS-CoV-2 |
| title_sort | case of primary covid 19 pneumonia plausible airborne transmission of sars cov 2 |
| topic | SARS-CoV-2 COVID-19 Airborne transmission Test Diagnosis Aerosols |
| url | https://doi.org/10.1186/s40001-022-00668-1 |
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