Taghizadieh Ali, Mikaeili Haleh, Ahmadi Majid, Valizadeh Hamed
Tuberculosis and Lung Disease Research Center of Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Internal Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Respir Med Case Rep. 2020 May 13;30:101090. doi: 10.1016/j.rmcr.2020.101090. eCollection 2020.
We reported a 33-year-old female case with novel coronavirus disease 2019 (COVID-19) accompanied by Acute tubular necrosis (ATN). She had a gestational age of 34 weeks. The patient referred to treatment clinic for COVID-19 in Imam Reza hospital of Tabriz (Iran) after having flu-like symptoms. In radiologic assessment, ground glass opacity (GGO) with consolidation was found in upper right lobe. Lopinavir/ritonavir (200mg/50mg) two tablet tow times, Ribavirin 200mg every 6 h, and Oseltamivir 75mg tow times were given for the treatment of COVID-19. The medications used for treatment of pneumonia were Meropenem, Ciprofloxacin, Vancomycin. All doses of medications were administrated by adjusted dose assuming the patient is anephric. Also, a few supplements were also given after ATN development including daily Rocaltrol and Nephrovit (as a multivitamin appropriate for patients with renal failure), Folic acid and Calcium carbonate. The patient is still under ventilator with a Fraction of inspired oxygen (FiO) of 60% and Positive end-expiratory pressure (PEEP) of eight. SpO is 94% but the patient's ATN problem has been resolved. We started weaning from mechanical ventilator. The patient is conscious with full awareness to time, person and place. The maternal well-being is achieved and her neonate was discharged.
我们报告了一例33岁的女性新型冠状病毒肺炎（COVID-19）病例，伴有急性肾小管坏死（ATN）。她的孕周为34周。该患者在出现流感样症状后前往大不里士（伊朗）伊玛目礼萨医院的COVID-19治疗诊所就诊。在影像学评估中，右上叶发现磨玻璃影（GGO）并伴有实变。给予洛匹那韦/利托那韦（200mg/50mg）两片，每日两次，利巴韦林200mg每6小时一次，以及奥司他韦75mg每日两次用于治疗COVID-19。用于治疗肺炎的药物有美罗培南、环丙沙星、万古霉素。假定患者无肾，所有药物剂量均进行了调整。在ATN发生后还给予了一些补充剂，包括每日罗钙全和肾维他（一种适合肾衰竭患者的多种维生素）、叶酸和碳酸钙。患者仍在使用呼吸机，吸入氧分数（FiO）为60%，呼气末正压（PEEP）为8。血氧饱和度（SpO）为94%，但患者的ATN问题已得到解决。我们开始撤机。患者意识清醒，对时间、人物和地点有完全的认知。产妇情况良好，其新生儿已出院。
