JMIR Publications

ABSTRACT

Background:

Novel corona virus (nCoV) or Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is known to cause severe bilateral pneumonia and acute respiratory distress syndrome (ARDS) or Corona virus disease-2019 (COVID-19) in patients that can be debilitating and even fatal. With no drugs or vaccines available yet, a wide range of treatment regimens used are being repurposed. The need of the hour is to analyze various regimens available and devise a treatment plan most effective against SARS-CoV-2.

Objective:

Patient concerns: A 68-year-old hypertensive, diabetic male, exhibiting symptoms of cough and shortness of breath presented at the emergency department of our hospital. Diagnosis: Chest CT revealed bilateral ground glass opacities indicative of COVID-19 and the CT score of 24 indicated severe pulmonary pneumonia. He tested positive for COVID-19.

Methods:

Interventions: The treatment regimen included use of convalescent plasma, oxygen therapy, steroids, high dose antibiotics, broad spectrum antiviral Remdesivir, and anti-interleukin-6 monoclonal antibody/Tocilizumab at various stages of the disease.

Results:

Outcomes: Oxygen support was required at the time of admission. The patient initially developed cytokine release storm and mechanical ventilation was used to manage his condition. Supportive care and multiple treatment regimens were used to successfully recover the patient’s health.

Conclusions:

Lessons: With a rapid increase in number of confirmed cases worldwide, COVID-19 has become a major challenge to our healthcare system. With no available vaccines currently, finding a combination of therapeutic drugs which are effective in reducing progression of disease is of utmost importance. Clinical Trial: Abbreviations:COVID-19=Corona virus disease 2019, nCoV=Novel corona virus (nCoV), SARS-CoV-2=Severe acute respiratory syndrome coronavirus 2, ARDS=acute respiratory distress syndrome, RT PCR= real-time polymerase chain reaction, SPO2= oxygen saturation, ICU=Intensive Care Unit, GGO=ground glass opacities, TDS=thrice daily, OD=once daily, BD= twice daily, CRS= cytokine release syndrome, CPAP=continuous positive airway pressure,FiO2= fraction of inspired oxygen, PEEP=positive end-expiratory pressure, PSV= pressure support ventilation.