Douedi Steven, Miskoff Jeffrey
Department of Medicine, Hackensack Meridian Jersey Shore University Medical Center Neptune.
Department of Medicine, Hackensack Meridian School of Medicine at Seton Hall University Nutley.
Medicine (Baltimore). 2020 May;99(19):e20207. doi: 10.1097/MD.0000000000020207.
Novel coronavirus 2019 (COVID-19) also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped, non-segmented positive-sense RNA virus belonging to the beta-coronaviridae family. This virus is known to cause severe bilateral pneumonia and acute respiratory distress syndrome (ARDS) which can lead to difficulty breathing requiring mechanical ventilation and intensive care unit management.
A 77-year-old female with a history of hypertension and hyperlipidemia who presented as a transfer to our hospital facility with worsening fevers, cough, and respiratory distress.
Chest X-rays revealed bilateral infiltrates worse at the lung bases and CT scan of the chest showed bilateral ground-glass opacities consistent with COVID-19. While our testing revealed a negative COVID-19 result at our institution, the result at a previous hospital returned a positive result.
She was being treated aggressively in the intensive care unit with high dose intravenous ascorbic acid, hydroxychloroquine, and anti-interleukin-6 monoclonal antibody. She also received a loading dose of remdesivir however was unable to complete the course due to organ failure and requirement of vasopressors for hemodynamic stability.
She remained critically ill and was eventually placed on comfort care as per the family's wishes and passed away.
With a rapidly growing death rate and more than 200,000 confirmed cases worldwide, COVID-19 has become a global pandemic and major hit to our healthcare systems. While several companies have already begun vaccine trials and healthcare facilities have been using a wide-range of medications to treat the virus and symptoms, there is not yet an approved medication regimen for COVID-19 infections. The alarming increase in cases per day adds additional pressure to find a cure and decrease the global health burden and mortality rate.
2019新型冠状病毒（COVID-19），也称为严重急性呼吸综合征冠状病毒2（SARS-CoV-2），是一种包膜的、不分节段的正链RNA病毒，属于β冠状病毒科。已知这种病毒会导致严重的双侧肺炎和急性呼吸窘迫综合征（ARDS），可导致呼吸困难，需要机械通气和重症监护病房管理。
一名77岁女性，有高血压和高脂血症病史，因发热、咳嗽和呼吸窘迫加重被转至我院。
胸部X光显示双侧肺底部浸润更严重，胸部CT扫描显示双侧磨玻璃样混浊，符合COVID-19表现。虽然我院检测结果为COVID-19阴性，但之前就诊医院的检测结果为阳性。
她在重症监护病房接受积极治疗，使用大剂量静脉注射维生素C、羟氯喹和抗白细胞介素-6单克隆抗体。她还接受了瑞德西韦的负荷剂量治疗，但由于器官衰竭和需要血管加压药来维持血流动力学稳定，未能完成疗程。
她病情一直危重，最终根据家人的意愿接受了舒适护理，随后去世。
随着全球死亡率迅速上升，确诊病例超过20万例，COVID-19已成为全球大流行疾病，对我们的医疗系统造成了重大冲击。虽然几家公司已经开始进行疫苗试验，医疗机构也一直在使用多种药物来治疗该病毒及其症状，但目前尚无针对COVID-19感染的批准用药方案。每日病例数的惊人增加给寻找治愈方法、减轻全球健康负担和降低死亡率带来了额外压力。
