A case of primary COVID-19 pneumonia: plausible airborne transmission of SARS-CoV-2
Bibliographic record
Abstract
BACKGROUND: The different clinical manifestations, from none to severe, and the variability in efficacy of SARS-CoV-2 diagnosis by upper respiratory tract testing, make diagnosis of COVID-19 and prevention of transmission especially challenging. In addition, the ways by which the virus can most efficiently transmit still remain unclear. CASE PRESENTATION: We report the case a 48-year-old man who presents primary COVID-19 pneumonia. He was initially admitted for cholecystitis but, upon review of his abdominal CT scan, a segmental zone of ground glass opacity was identified in the right lower lobe. A bronchoalveolar lavage proved positive to SARS-CoV-2 by RT-qPCR, even if he tested negative by oro-nasopharyngeal swab at admission and the day after he underwent bronchoscopy. The near absence of the virus in his saliva 2 days after, combined with a very sharp increase in salivary viral load on the third day, also rule out the possibility of prior viral replication in the upper airway and clearance. In addition, rapidly increasing bilateral alveolar lung infiltrates appeared as the upper respiratory tests begin to detect the virus. CONCLUSIONS: For this patient to have developed primary COVID-19 pneumonia, a contagious aerosol must have traveled to the lower respiratory system. This case gives indirect but compelling evidence that aerosol may spread the virus. It also highlights the limitations of oral and nasal testing methods and the importance of anatomical considerations when studying infections by SARS-CoV-2.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".