Virological assessment of hospitalized patients with COVID-2019

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dc.creatorWölfel, Roman
dc.creatorCorman, Victor M.
dc.creatorGuggemos, Wolfgang
dc.creatorSeilmaier, Michael
dc.creatorZange, Sabine
dc.creatorMüller, Marcel A.
dc.creatorNiemeyer, Daniela
dc.creatorJones, Terry C.
dc.creatorVollmar, Patrick
dc.creatorRothe, Camilla
dc.creatorHoelscher, Michael
dc.creatorBleicker, Tobias
dc.creatorBrünink, Sebastian
dc.creatorSchneider, Julia
dc.creatorEhmann, Rosina
dc.creatorZwirglmaier, Katrin
dc.creatorDrosten, Christian
dc.creatorWendtner, Clemens
dc.date.accessioned2020-07-16T15:15:05Z
dc.date.available2020-07-16T15:15:05Z
dc.date.created2020-04-01
dc.description.abstractenglishCoronavirus disease 2019 (COVID-19) is an acute infection of the respiratory tract that emerged in late 20191,2. Initial outbreaks in China involved 13.8% of cases with severe courses, and 6.1% of cases with critical courses3. This severe presentation may result from the virus using a virus receptor that is expressed predominantly in the lung2,4; the same receptor tropism is thought to have determined the pathogenicity—but also aided in the control—of severe acute respiratory syndrome (SARS) in 20035. However, there are reports of cases of COVID-19 in which the patient shows mild upper respiratory tract symptoms, which suggests the potential for pre- or oligosymptomatic transmission6,7,8. There is an urgent need for information on virus replication, immunity and infectivity in specific sites of the body. Here we report a detailed virological analysis of nine cases of COVID-19 that provides proof of active virus replication in tissues of the upper respiratory tract. Pharyngeal virus shedding was very high during the first week of symptoms, with a peak at 7.11 × 108 RNA copies per throat swab on day 4. Infectious virus was readily isolated from samples derived from the throat or lung, but not from stool samples—in spite of high concentrations of virus RNA. Blood and urine samples never yielded virus. Active replication in the throat was confirmed by the presence of viral replicative RNA intermediates in the throat samples. We consistently detected sequence-distinct virus populations in throat and lung samples from one patient, proving independent replication. The shedding of viral RNA from sputum outlasted the end of symptoms. Seroconversion occurred after 7 days in 50% of patients (and by day 14 in all patients), but was not followed by a rapid decline in viral load. COVID-19 can present as a mild illness of the upper respiratory tract. The confirmation of active virus replication in the upper respiratory tract has implications for the containment of COVID-19.spa
dc.format.extent12 páginasspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.doihttps://doi.org/10.1038/s41586-020-2196-xspa
dc.identifier.issn1476-4687spa
dc.identifier.otherhttps://www.nature.com/articles/s41586-020-2196-xspa
dc.identifier.urihttps://hdl.handle.net/20.500.12010/10645
dc.publisherScience Directeng
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.sourcereponame:Expeditio Repositorio Institucional UJTLspa
dc.sourceinstname:Universidad de Bogotá Jorge Tadeo Lozanospa
dc.subjectEvaluación virológicaspa
dc.subjectPacientes hospitalizadosspa
dc.subject.keywordVirological assessmentspa
dc.subject.lembSíndrome respiratorio agudo gravespa
dc.subject.lembCOVID-19spa
dc.subject.lembSARS-CoV-2spa
dc.subject.lembCoronavirusspa
dc.subject.lembHospitalized patientsspa
dc.titleVirological assessment of hospitalized patients with COVID-2019spa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.type.localArtículospa

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