Abstract
The main object of the study was to investigate the SARS-CoV-2 molecular and serological pattern in patients with mild symptoms including anosmia and ageusia. A cohort of 69 patients with olfactory and taste disorders (OTDs) were enrolled and prospectively monitored. Serological and molecular assays for the characterization of SARS-CoV-2 IgG and SARS-CoV-2 RNA, respectively, were performed at the time of enrolment and after 7 and 14 days. Patients were stratified according to the symptoms’ onset. A total of 52 patients (75.4%) were diagnosed as COVID-19 positive being SARS-CoV-2 RNA and/or SARS-CoV-2 IgG positive. The remaining 17 (24.6%) were negative for COVID-19 and excluded from the analysis. We reported that only 34 out of 52 patients (65.4%) were positive for SARS-CoV-2 RNA. Moreover, the median time from onset of symptoms and enrolment was significantly higher in those patients with negative SARS-CoV-2 RNA in nasal swabs, suggesting that symptoms might last longer than SARS-CoV-2 replication. The great majority of patients (80%) developed SARS-CoV-2 IgG at three weeks after symptoms’ onset while the detectability of SARS-CoV-2 RNA dramatically decreased over time, suggesting the crucial role of combination of molecular and serological assays for the diagnosis of COVID-19 in those patients reporting mild symptoms.
Highlights
Human coronaviruses (CoVs) are enveloped viruses with a single strand positive-sense RNA genome, belonging to the family Coronaviridae and divided into to four genus alpha-CoV (Group 1), beta-CoV (Group 2) within four lineages (A, B, C and D) are recognized, gamma-CoV (Group 3) and delta-CoV (Group 4)
Despite that the largest part of human coronaviruses are mainly responsible for mild seasonal respiratory diseases, in 2003, a human coronavirus (SARS-CoV) caused the severe acute respiratory syndrome coronavirus (SARS) outbreak [2] and, in June 2012, 10 years after the first emergence of SARS-CoV, a novel coronavirus, Middle East respiratory syndrome coronavirus (MERS-CoV), was isolated in a man in Saudi Arabia died of acute pneumonia and renal failure [3]
The large part of enrolled subjects never smoked (69.2%) and did not show comorbidities (73.1%); seasonal influenza vaccination was reported only in 13.5% of the individuals while none traveled in risky areas for COVID-19
Summary
Human coronaviruses (CoVs) are enveloped viruses with a single strand positive-sense RNA genome, belonging to the family Coronaviridae (subfamily Orthocoronavirinae) and divided into to four genus alpha-CoV (Group 1), beta-CoV (Group 2) within four lineages (A, B, C and D) are recognized, gamma-CoV (Group 3) and delta-CoV (Group 4). Strains HCoV-229E and HCoV-NL63 are included in alphacoronavirus genus, while HCoV-OC43, HCoV-HKU1, MERS and SARS are members of the betacoronavirus genus [1]. HCoVs come from animal reservoirs such as bats for NL63, SARS-CoV, and MERS while OC43 and HKU1 come from rodents [4]. HCoVs spread from the animal host into the human population via an intermediate host species (cows, civets, camels, pangolins and minks) [4,5]. No vaccines or specific therapies against HCoVs are available in order to prevent coronavirus infections; good hygienic practice and investigation of epidemiological features are necessary
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