Novel Coronavirus (2019-nCoV) in Disguise

Zhang, Qian; Douglas, Annyella; Abideen, Zain Ul; Khanal, Shristi; Tzarnas, Stephanie

doi:10.7759/cureus.7521

Cited by 8 publications

(8 citation statements)

References 6 publications

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“…Patients should wear facial mask and reside in rooms with closed doors. Healthcare workers should also have personal protective equipment (PPE) and do precautions before confronting the patients [ 4 , 16 ]. However, in cases with atypical symptoms such as ours, it is challenging to have adequate precautions instantly after exposure to the patients.…”

Section: Discussionmentioning

confidence: 99%

Atypical presentation of COVID-19; an observational retrospective study

et al. 2020

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Background COVID-19 infection may present with atypical signs and symptoms and false negative polymerase chain reaction (PCR) tests predisposing healthy people and health care workers to infection. The aim of the current study is to evaluate the features of atypical presentations in COVID-19 infection in a referral center in Tehran, Iran. Methods Hospital database of inpatients admitted to Loghman Hakim hospital between February 20th and May 11th, 2020 was reviewed and all patients with final diagnosis of COVID-19 infection were evaluated for their presenting symptoms. Patients with chief complaints of “fever”, “dyspnea”, and/or “cough” as typical presentations of COVID-19 were excluded and those with other clinical presentations were included. Results Nineteen patients were included with a mean age of 51 ± 19 years, of whom, 17 were males (89%). Median [IQR] Glasgow coma scale (GCS) was 14 [13, 15]. Almost 10 had referred with chief complaint of methanol poisoning and overdose on substances of abuse. Only 8 cases (42%) had positive COVID-19 test. Nine (47%) needed invasive mechanical ventilation, of whom, two had positive COVID-19 test results (p = ns). Eight patients (42%) died with three of them having positive PCRs. Conclusions In patients referring to emergency departments with chief complaint of poisoning (especially poisonings that can result in dyspnea including substances of abuse and toxic alcohols), gastrointestinal, and constitutional respiratory symptoms, attention should be given not to miss possible cases of COVID-19.

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Section: Discussionmentioning

confidence: 99%

Atypical presentation of COVID-19; an observational retrospective study

et al. 2020

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“…According to the published SARS-CoV-2 whole genome sequence [8], we designed 7 sgRNAs around the RdRp locus, as recommended by the World Health Organization (WHO) [2] (Supplementary information, Fig. S2a).…”

Section: Resultsmentioning

confidence: 99%

SARS-CoV-2 detection with CRISPR diagnostics

Guo

Sun

Wang

et al. 2020

Preprint

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The novel coronavirus (CoV) disease termed caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) is causing a massive pandemic worldwide, threatening public health systems across the globe. During this ongoing COVID-19 outbreak, nucleic acid detection has played an important role in early diagnosis. Here we report a SARS-CoV-2 detection protocol using a CRISPR-based CRISPR diagnostic platform -CDetection (Cas12b-mediated DNA detection). By combining sample treatment protocols and nucleic acid amplification methods with CDetection, we have established an integrated viral nucleic acid detection platform -CASdetec (CRISPR-assisted detection). The detection limit of CASdetec for SARS-CoV-2 pseudovirus is 1 × 10 4 copies/mL, with no cross reactivity observed. Our assay design and optimization process can provide guidance for future CRISPR-based nucleic acid detection assay development and optimization.

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“…The genitourinary category has very little evidence and is fairly novel. Dysuria has been shown to be a presenting complaint for COVID-19 in case studies but seems to be atypical [ 19 ]. Having a relatively low patient population that presented with GU symptoms (44/16867) is a potential limitation in our data.…”

Section: Discussionmentioning

confidence: 99%

Association between COVID-19 diagnosis and presenting chief complaint from New York City triage data

Clifford

Pour

Freeman

et al. 2021

The American Journal of Emergency Medicine

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Background and aim New York City (NYC) is an epicenter of the COVID-19 pandemic in the United States. Proper triage of patients with possible COVID-19 via chief complaint is critical but not fully optimized. This study aimed to investigate the association between presentation by chief complaints and COVID-19 status. Methods We retrospectively analyzed adult emergency department (ED) patient visits from five different NYC hospital campuses (hospital blinded) from March 1, 2020 to May 13, 2020 of patients who underwent nasopharyngeal COVID-19 RT-PCR testing. The positive and negative COVID-19 cohorts were then assessed for different chief complaints obtained from structured triage data. Sub-analysis was performed for patients older than 65 and within chief complaints with high mortality. Results Of 11,992 ED patient visits who received COVID-19 testing, 6524/11992 (54.4%) were COVID-19 positive. 73.5% of fever, 67.7% of shortness of breath, and 65% of cough had COVID-19, but others included 57.5% of weakness/fall/altered mental status, 55.5% of glycemic control, and 51.4% of gastrointestinal symptoms. In patients over 65, 76.7% of diarrhea, 73.7% of fatigue, and 69.3% of weakness had COVID-19. 45.5% of dehydration, 40.5% of altered mental status, 27% of fall, and 24.6% of hyperglycemia patients experienced mortality. Conclusion A novel high risk COVID-19 patient population was identified from chief complaint data, which is different from current suggested CDC guidelines, and may help triage systems to better isolate COVID-19 patients. Older patients with COVID-19 infection presented with more atypical complaints warranting special consideration. COVID-19 was associated with higher mortality in a unique group of complaints also warranting special consideration.

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Novel Coronavirus (2019-nCoV) in Disguise

Cited by 8 publications

References 6 publications

Atypical presentation of COVID-19; an observational retrospective study

Atypical presentation of COVID-19; an observational retrospective study

SARS-CoV-2 detection with CRISPR diagnostics

Association between COVID-19 diagnosis and presenting chief complaint from New York City triage data

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