Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2020; 8(23): 6056-6063
Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.6056
Suspected SARS-CoV-2 infection with fever and coronary heart disease: A case report
Jin-Ru Gong, Jia-Sheng Yang, Yao-Wei He, Kang-Hui Yu, Jia Liu, Rui-Lin Sun
Jin-Ru Gong, Jia-Sheng Yang, Yao-Wei He, Jia Liu, Rui-Lin Sun, Department of Pulmonary and Critical Care Medicine, Guangdong Second Provincial General Hospital, Guangzhou 510317, Guangdong Province, China
Kang-Hui Yu, Department of Radiology, Guangdong Second Provincial General Hospital, Guangzhou 510317, Guangdong Province, China
Author contributions: Gong JR and Yang JS conceived the report and contributed to manuscript drafting; Gong JR analyzed and interpreted the patient data; He YW reviewed the literature and contributed to manuscript drafting and study supervision; Yu KH, Liu J, and Sun RL reviewed the literature and drafted the manuscript; All authors gave final approval for the version to be submitted.
Supported by Guangdong Provincial Novel Coronavirus Scientific and Technological Project, No. 2020111107001.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and accompanying images.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui-Lin Sun, MD, PhD, Chief Doctor, Chief Physician, Staff Physician, Department of Pulmonary and Critical Care Medicine, Guangdong Second Provincial General Hospital, No. 466 Xingang Middle Road, Guangzhou 510317, Guangdong Province, China. sunruilin213@126.com
Received: June 12, 2020
Peer-review started: June 12, 2020
First decision: September 13, 2020
Revised: September 27, 2020
Accepted: October 13, 2020
Article in press: October 13, 2020
Published online: December 6, 2020
Processing time: 174 Days and 24 Hours
Abstract
BACKGROUND

The coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Suspected cases accounted for a large proportion in the early stage of the COVID-19 outbreak. The deviation of the nucleic acid test by throat swab (the current gold standard of COVID-19) caused by variation in sampling techniques and reagent kits and coupled with nonspecific clinical manifestations make confirmation of the suspected cases difficult. Proper management of the suspected cases of COVID-19 is crucial for disease control.

CASE SUMMARY

A 65-year-old male presented with fever, lymphopenia, and chest computed tomography (CT) images similar to COVID-19 after percutaneous coronary intervention. The patient was diagnosed as having bacterial pneumonia with cardiogenic pulmonary edema instead of COVID-19. This was based on four negative results for throat swab detection of SARS-CoV-2 nucleic acid using reverse transcriptase-polymerase chain reaction assay and one negative result for serological antibody of SARS-CoV-2 with the serological assay. Additionally, the distribution of ground-glass opacities and thickened blood vessels from the CT images differed from COVID-19 features, which further supported the exclusion of COVID-19.

CONCLUSION

Distinguishing COVID-19 patients from those with bacterial pneumonia with cardiogenic pulmonary edema can be difficult. Therefore, it requires serious identification.

Keywords: COVID-19; Suspected case; Nucleic acid test; Serological antibody detection; Ground-glass opacities; Case report

Core Tip: A 65-year-old male presented with fever, lymphopenia, and similar computed tomography (CT) findings of coronavirus disease 2019 after percutaneous coronary intervention. The patient was diagnosed with bacterial pneumonia with cardiogenic pulmonary edema following the negative results from the nucleic acid test and serological detection of severe acute respiratory syndrome coronavirus 2, ground-glass opacities mainly in parahilar regions from the CT images, and treatment response. This report suggested that serious identification is required to distinguish COVID-19 and common pneumonia.