Case of the Index Patient Who Caused Tertiary Transmission of COVID-19 Infection in Korea: the Application of Lopinavir/Ritonavir for the Treatment of COVID-19 Infected Pneumonia Monitored by Quantitative RT-PCR

Jaegyun Lim, Seunghyun Jeon, Hyun Young Shin, Moon Jung Kim, Yu Min Seong, Wang Jun Lee, Kang Won Choe, Yu Min Kang, Baeckseung Lee, Sang Joon Park, Jaegyun Lim, Seunghyun Jeon, Hyun Young Shin, Moon Jung Kim, Yu Min Seong, Wang Jun Lee, Kang Won Choe, Yu Min Kang, Baeckseung Lee, Sang Joon Park

Abstract

Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.

Keywords: COVID-19; Coronavirus; Pneumonia; Real-Time Reverse-Transcriptase Polymerase Chain Reaction; Tertiary Infection; Viral Load.

Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

© 2020 The Korean Academy of Medical Sciences.

Figures

Fig. 1. Radiologic findings of the patient.
Fig. 1. Radiologic findings of the patient.
(A) Chest X-ray of illness day 3, hospital day 1. (B) Chest X-ray of illness day 9, hospital day 7. (C) Chest X-ray of illness day 15, hospital day 13. (D) HRCT scan of illness day 9, hospital day 7. (E) HRCT scan of illness day 15, hospital day 13. AP(P) = Anteroposterior (Portable X-ray), HRCT = high-resolution computed tomography.
Fig. 2. Clinical course, treatment and viral…
Fig. 2. Clinical course, treatment and viral load of the patient.
RdRP = RNA-dependent RNA polymerase, Posi = positive, Nega = negative, UD = undeteced, Ct = cycle threshold.

References

    1. Kim JY, Choe PG, Oh Y, Oh KJ, Kim J, Park SJ, et al. The first case of 2019 novel coronavirus pneumonia imported into Korea from Wuhan, China: implication for infection prevention and control measures. J Korean Med Sci. 2020;35(5):e61.
    1. Hamer M, Kivimaki M, Stamatakis E, Batty GD. Psychological distress and infectious disease mortality in the general population. Brain Behav Immun. 2019;76:280–283.
    1. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020 doi: 10.1056/NEJMoa2001316.
    1. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al. Transmission of 2019-nCoV Infection from an asymptomatic contact in Germany. N Engl J Med. 2020 doi: 10.1056/NEJMc2001468.
    1. Chang D, Lin M, Wei L, Xie L, Zhu G, Dela Cruz CS, et al. Epidemiologic and clinical characteristics of novel coronavirus infections involving 13 patients outside Wuhan, China. JAMA. 2020 doi: 10.1001/jama.2020.1623.

Source: PubMed

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