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?:abstract
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A 65 year-old man was hospitalized due to fever (38 6 degrees C) and dry cough since 4 days He visited Wuhan 8 days ago At admission, nasopharyngeal swabs sample were taken and PCR analysis confirmed SARS-CoV-2RNA positivity On day 9 after admission, chest CT scan showed diffuse ground-glass shadows in patient\'s bilateral lungs On day 11, his respiratory symptoms worsened Subsequently, type 1 respiratory failure was diagnosed, coinciding with kidney injury, and subsequently, type 2 respiratory failure occurred, coupled with multi-organ failure including heart and liver However, patient constitution worsened although SARS-CoV-2 tests were negative since day 13 He died on day 21 Lung biopsy showed areas of diffuse alveolar damage, characterized by extensive acute alveolitis with numerous intra-alveolar neutrophils, lymphocytes and macrophages infiltrations Microthrombi were seen in the dilated pulmonary capillaries Immunohistochemistry stainings for SARS-CoV-2-N protein was negative Taken together, the patient died of multiorgan failure although the SARS-CoV-2 infection was cleared already, implicating that for disease worsening, no active SARS-CoV-2 infection is required
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