NETEC Resource Library

Clinical and virological data of the first cases of COVID-19 in Europe: a case series

Item

Click for External Resource*


Click to read full article*


*The link above may share a zip file (.zip) hosted on repository.netecweb.org. Zip files will download automatically.
*All other links are external and will open in a new window. If you click an external link, you are leaving the NETEC site, and we do not maintain, review, or endorse these materials. See our terms of use.


Item Type

Publication

Terms of Use

By accessing these materials you are agreeing to our terms of use, which may be found here: Terms of Use.

Was this resource helpful?


Title

Clinical and virological data of the first cases of COVID-19 in Europe: a case series

Subject

Description

In this case series, we followed five patients admitted to Bichat-Claude Bernard University Hospital (Paris, France) and Pellegrin University Hospital (Bordeaux, France) and diagnosed with COVID-19 by semi-quantitative RT-PCR on nasopharyngeal swabs.

A response to article was published:

Date

2020-03-27

Citation

Lescure, Francois-Xavier, Lila Bouadma, Duc Nguyen, Marion Parisey, Paul-Henri Wicky, Sylvie Behillil, Alexandre Gaymard, Maude Bouscambert-Duchamp, Flora Donati, Quentin Le Hingrat, Vincent Enouf, Nadhira Houhou-Fidouh, Martine Valette, Alexandra Mailles, Jean-Christophe Lucet, France Mentre, Xavier Duval, Diane Descamps, Denis Malvy, Jean-François Timsit, Bruno Lina, Sylvie van-der-Werf, and Yazdan Yazdanpanah. 2020. "Clinical and virological data of the first cases of COVID-19 in Europe: a case series." The Lancet Infectious Diseases.

Abstract

Background

On Dec 31, 2019, China reported a cluster of cases of pneumonia in people at Wuhan, Hubei Province. The responsible pathogen is a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report the relevant features of the first cases in Europe of confirmed infection, named coronavirus disease 2019 (COVID-19), with the first patient diagnosed with the disease on Jan 24, 2020.

Methods

In this case series, we followed five patients admitted to Bichat-Claude Bernard University Hospital (Paris, France) and Pellegrin University Hospital (Bordeaux, France) and diagnosed with COVID-19 by semi-quantitative RT-PCR on nasopharyngeal swabs. We assessed patterns of clinical disease and viral load from different samples (nasopharyngeal and blood, urine, and stool samples), which were obtained once daily for 3 days from hospital admission, and once every 2 or 3 days until patient discharge. All samples were refrigerated and shipped to laboratories in the National Reference Center for Respiratory Viruses (The Institut Pasteur, Paris, and Hospices Civils de Lyon, Lyon, France), where RNA extraction, real-time RT-PCR, and virus isolation and titration procedures were done.

Findings

The patients were three men (aged 31 years, 48 years, and 80 years) and two women (aged 30 years and 46 years), all of Chinese origin, who had travelled to France from China around mid-January, 2020. Three different clinical evolutions are described: (1) two paucisymptomatic women diagnosed within a day of exhibiting symptoms, with high nasopharyngeal titres of SARS-CoV-2 within the first 24 h of the illness onset (5·2 and 7·4 log10 copies per 1000 cells, respectively) and viral RNA detection in stools; (2) a two-step disease progression in two young men, with a secondary worsening around 10 days after disease onset despite a decreasing viral load in nasopharyngeal samples; and (3) an 80-year-old man with a rapid evolution towards multiple organ failure and a persistent high viral load in lower and upper respiratory tract with systemic virus dissemination and virus detection in plasma. The 80-year-old patient died on day 14 of illness (Feb 14, 2020); all other patients had recovered and been discharged by Feb 19, 2020.

Interpretation

We illustrated three different clinical and biological types of evolution in five patients infected with SARS-CoV-2 with detailed and comprehensive viral sampling strategy. We believe that these findings will contribute to a better understanding of the natural history of the disease and will contribute to advances in the implementation of more efficient infection control strategies.

Funding

REACTing (Research & Action Emerging Infectious Diseases).

Accessibility

Free online on Lancet site.

Collection