No symptoms suspect for recurrence of COVID-19 have been detected since discharge.Ĭase 2: A 78-year-old man with chronic heart failure by old myocardial infarction and hypertension was admitted to our hospital after being diagnosed with COVID-19.
During hospitalization, we did not administer any antiviral or steroid therapy but provided only conservative and supportive care such as administering antipyretics and implementing measures to deep vein thrombosis. Chest CT findings gradually improved following the seroconversion of viral RNA to negative and improvement of general condition ( Fig. 2). He was discharged on day 20 after confirming 2 consecutive negative RT-PCR results from oropharyngeal swab samples ( Fig. 1-A), in line with the criteria for discharge in Japan. The RT-PCR result became negative on day 13 ( Fig. 1-A), after which respiratory status improved and fever decreased. On day 9 of his illness, oxygen saturation could not be maintained under nasal oxygen therapy, so high-flow nasal oxygen therapy was started at 40L/min and 40%, ( Fig. 1-A). We then retrospectively performed RT-PCR of a serum sample that had been collected on admission (day 6 of illness) and stored at −80 ☌. The positive test result was found on examination of serum samples for SARS-CoV-2 RNA by RT-PCR performed in accordance with recommendation by Japan's National Institute of Infectious Disease. Given that a previous report on viremia in cases of influenza A H1N1/09 described deteriorating respiratory symptoms and/or high fever coinciding with the detection of influenza A H1N1RNA in blood, we suspected a correlation with viremia in COVID-19 also. Respiratory status gradually deteriorated and his body temperature increased to 39 ☌ on day 8 of his illness. C) Day 17 of his illness, consolidation on dorsal side tend to disappear, however new ground glass opacity appeared on right middle lobe and left S 8. B) Day 11 of his illness, consolidation on the dorsal side increased in extent. Chest CT images of Case 1 patient during hospitalization: A) Day 8 of his illness, peripheral ground-glass opacity and consolidation on both lower lobes.