A woman with fever and cough: coronavirus disease 2019

Excerpt

A 64-year-old woman presented to the emergency department on February 1st, 2020, because of a 7-day fever, with the highest body temperature of 38.7 °C, accompanied by cough with a little sputum and muscle soreness, but no chest distress or dyspnea. She just flew back to Hangzhou, China, from Malaysia 7 days ago. Physical examination revealed no dry and moist rales in both lungs with a temperature of 37.3 °C, heart rate of 92 beats/min, respiratory rate of 18 times/min, and blood pressure of 113/79 mmHg. Her laboratory tests showed white blood cell count (WBC) was 2.5 × 10⁹ cells/mL with 63.3% neutrophils and 29.2% lymphocytes, and C-reactive protein (CRP) level was 3.62 mg/L. Her sputum test for influenza A + B (real-time fluorescent RT-PCR) was negative, and the lung CT images were shown in Fig. 1. The lung CT images of this patient showed multiple ground-glass shadows with unclear edges and uneven densities in the peripheral and posterior lungs, mainly under the pleura. These imagings were in accordance with the early radiographic features of coronavirus disease 2019 (COVID-19). Later, the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) RNA was detected in the sputum by real-time fluorescent RT-PCR, and the patient was diagnosed as COVID-19.

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