COVID-19 is a respiratory disease pandemic that has swept across the world, causing over 282,495 deaths (May 10, 2020). Patients most commonly present at hospitals with influenza-like illness (ILI). The causative agent of COVID-19, the coronavirus SARS-CoV-2, has no vaccine, and no drugs have been proven effective in clinical trials. The first reported cases occurred in late December 2019, clustered around a market in Wuhan China. France reported its first cases of SARS-CoV-2 infection on January 24, 2020.
Yves Cohen of Groupe Hospitalier Paris Seine Saint-Denis, France, and colleagues reasoned that since the clinical symptoms of COVID-19 and ILIs is similar it might be informative to retrospectively look for SARS-CoV-2 in respiratory samples collected and biobanked from the intensive care unit (ICU) of their hospital near Paris. The results were published in the International Journal of Antimicrobial Agents.
ICU patients admitted for ILI between 2 December 2019 and 16 January 2020 with a negative reverse transcription PCR (RT-PCR) performed at admission had their medical records retrospectively reviewed. Nasopharyngeal samples from 124 of these patients were again screened for a wide range of viral and bacterial pathogens using The BioFire® FilmArray® RT-PCR panel.
The screening revealed positive patient results including 14 influenza, 3 common coronavirus, and 28 other pathogens. These were excluded from further study. The medical records of the remaining patients were then reviewed for pulmonary ground-glass opacity, a typical sign of COVID-19, and excluded if this was not present. Therefore 14 patients remained with COVID-like symptoms and negative PCRs for common pathogens.
These 14 samples were specifically screened for SARS-CoV-2 by RT-PCR using primers against RdRp, E and N virus genes. One sample from a patient who presented to the emergency ward on 27 December 2019 was positive.
The patient was a 42-year-old unemployed male born in Algeria who had lived in France for many years. His last foreign trip was to Algeria in August 2019. His medical history included asthma and type II diabetes mellitus. He received antibiotic therapy (the virus was unknown at the time) and his condition improved until discharge on 29 December 2019.
“Further studies are required to evaluate the actual onset of SARS-CoV-2 in the French territory as well as the extent of SARS- CoV-2 contamination in the population during late 2019 and January 2020 and to explore the potential unnoticed deaths that could have happen at the time,” concluded the authors.