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      Clinical and virologic characteristics of the first 12 patients with coronavirus disease 2019 (COVID-19) in the United States

      The COVID-19 Investigation Team
      Nature Medicine
      Springer Science and Business Media LLC

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          Abstract

          Data on the detailed clinical progression of COVID-19 in conjunction with epidemiological and virological characteristics are limited. In this case series, we describe the first 12 US patients confirmed to have COVID-19 from 20 January to 5 February 2020, including 4 patients described previously1-3. Respiratory, stool, serum and urine specimens were submitted for SARS-CoV-2 real-time reverse-transcription polymerase chain reaction (rRT-PCR) testing, viral culture and whole genome sequencing. Median age was 53 years (range: 21-68); 8 patients were male. Common symptoms at illness onset were cough (n = 8) and fever (n = 7). Patients had mild to moderately severe illness; seven were hospitalized and demonstrated clinical or laboratory signs of worsening during the second week of illness. No patients required mechanical ventilation and all recovered. All had SARS-CoV-2 RNA detected in respiratory specimens, typically for 2-3 weeks after illness onset. Lowest real-time PCR with reverse transcription cycle threshold values in the upper respiratory tract were often detected in the first week and SARS-CoV-2 was cultured from early respiratory specimens. These data provide insight into the natural history of SARS-CoV-2. Although infectiousness is unclear, highest viral RNA levels were identified in the first week of illness. Clinicians should anticipate that some patients may worsen in the second week of illness.

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          Author and article information

          Journal
          Nature Medicine
          Nat Med
          Springer Science and Business Media LLC
          1078-8956
          1546-170X
          April 23 2020
          Article
          10.1038/s41591-020-0877-5
          32327757
          61606764-659b-4d68-adb6-094e2c4b5ac7
          © 2020

          Free to read

          http://www.springer.com/tdm

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