SARS-CoV-2 infection diagnosed only by cell culture isolation before the local outbreak in an Italian seven-week-old suckling baby

• Published in: International journal of infectious diseases Vol. 96; pp. 387 - 389
• Main Authors: Calderaro, Adriana, Arcangeletti, Maria Cristina, De Conto, Flora, Buttrini, Mirko, Montagna, Paolo, Montecchini, Sara, Ferraglia, Francesca, Pinardi, Federica, Chezzi, Carlo
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.07.2020; The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases; Elsevier
• Subjects: Betacoronavirus - isolation & purification; Case Report; Cell culture; Cells, Cultured; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; COVID-19; Diagnosis; Disease Outbreaks; Humans; Infant; Italy - epidemiology; Male; Pandemics; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; SARS-CoV-2; Suckling baby; Italy; COVID-19; Cell culture; SARS-CoV-2; Diagnosis; Suckling baby
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2020.05.035

[Display omitted] •The study described the case of a 7-week-old suckling baby infected withSARS-CoV-2 virus.•Only culture isolation allowed the identification of the cytopathogenic agent.•Cell culture still remains the only reference method for emerging viruses. SARS-CoV-2 emerged in China in December 2019 and has now been declared a pandemic by the World Health Organization. This paper described the case of a 7-week-old suckling baby from Italy who was SARS-CoV-2-positive only by the cell culture method, with no clinical suspicion of and/or risk factors for SARS-CoV-2 infection. The baby was referred to hospital, with signs and symptoms of upper respiratory tract infection, before the virus had spread to the province. Nasal and pharyngeal swabs and a nasopharyngeal aspirate were used for conventional and molecular diagnostic assays not including the SARS-CoV-2 virus. Bacteria referred to the resident population were revealed in nasal and pharyngeal swabs. No viruses were detected using both immunofluorescence assay and nucleic acid amplification assays in the nasopharyngeal aspirate. The baby was discharged in good condition after 3 days of hospitalisation. Later, a cytopathic effect on the cell monolayers currently used for respiratory viruses was observed and the viral particles were identified as Coronaviridae by transmission electron microscopy. SARS-CoV-2 was identified by RT-PCR performed both on cell culture and on the stored aliquot of the original sample. The virus isolate was named SARS-Cov-2/human/Parma/1/2020. Cell culture still remains the only reference diagnostic method also for emerging viruses, allowing it to reveal cytopathogenic viruses and demonstrate their infectivity.