First Case of 2019 Novel Coronavirus in the United States

Abstract

An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient's initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.

Figure 1. Posteroanterior and Lateral Chest Radiographs, January 19, 2020 (Illness Day 4).

No thoracic abnormalities were noted.

Figure 2. Symptoms and Maximum Body Temperatures According to Day of Illness and Day of Hospitalization, January 16 to January 30, 2020.

Figure 3. Posteroanterior and Lateral Chest Radiographs, January 22, 2020 (Illness Day 7, Hospital Day 3).

No acute intrathoracic plain-film abnormality was noted.

Figure 4. Posteroanterior Chest Radiograph, January 24, 2020 (Illness Day 9, Hospital Day 5).

Increasing left basilar opacity was visible, arousing concern about pneumonia.

Figure 5. Anteroposterior and Lateral Chest Radiographs, January 26, 2020 (Illness Day 10, Hospital Day 6).

Stable streaky opacities in the lung bases were visible, indicating likely atypical pneumonia; the opacities have steadily increased in density over time.