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A Community-transmitted Case of Severe Acute Respiratory Distress Syndrome (SARS) Due to SARS-CoV-2 in the United States

Clin Infect Dis. 2020 Nov 19;71(16):2222-2226. doi: 10.1093/cid/ciaa347.

Abstract

This is the first known community transmission case of the novel coronavirus disease (COVID-19) in the United States, with significant public health implications. Diagnosis of COVID-19 is currently confirmed with PCR based testing of appropriate respiratory samples. Given the absence of travel or known exposure history, this patient did not meet the criteria for testing according to CDC guidelines at the time of her presentation. Since this case, any patient with severe disease (eg, ARDS or pneumonia) requiring hospitalization without an explanatory diagnosis can be tested even if no clear source of exposure is identified. While influencing national health policies for revising screening criteria, this case also highlighted significant knowledge gaps in diagnosis and treatment and a desperate need for early, widespread, fast and cheap testing for COVID-19.

Keywords: COVID-19; SARS-CoV-2; community transmission; index case; novel coronavirus.

Publication types

  • Case Reports

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives
  • Adenosine Monophosphate / therapeutic use
  • Adult
  • Alanine / analogs & derivatives
  • Alanine / therapeutic use
  • Antiviral Agents / therapeutic use
  • COVID-19 / complications
  • COVID-19 / diagnostic imaging*
  • COVID-19 Drug Treatment
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / virology*
  • Female
  • Humans
  • Middle Aged
  • Respiratory Distress Syndrome / diagnostic imaging
  • Respiratory Distress Syndrome / virology*
  • Risk Factors
  • Shock, Septic / etiology
  • Thorax / diagnostic imaging
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • United States / epidemiology

Substances

  • Antiviral Agents
  • remdesivir
  • Adenosine Monophosphate
  • Alanine