Ng Kenneth K, Ng Mitchell K, Zhyvotovska Angelina, Singh Sahib, Shevde Ketan
Anesthesiology, State University of New York Downstate Medical Center, Brooklyn, USA.
Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, USA.
Cureus. 2020 May 25;12(5):e8268. doi: 10.7759/cureus.8268.
A 74-year-old male was admitted to the Intensive Care Unit (ICU) at State University of New York (SUNY) Downstate Medical Center following acute respiratory failure secondary to coronavirus disease 2019 (COVID-19) viral pneumonia. The patient had significant comorbidities, including a history of lung and esophageal cancer status-post resection, cerebrovascular accident with neurological deficits, diabetes mellitus, hypertension, and peripheral vascular disease. The patient was in septic shock and respiratory failure on admission requiring intubation and mechanical ventilation. Computed tomography (CT) of the chest showed patchy bilateral opacities suspicious for viral pneumonia and the COVID-19 sputum sample sent to the New York Department of Health returned positive. This patient's comorbidities, along with his age, placed him in the highest risk of mortality for COVID-19. The patient was managed pharmacologically with hydroxychloroquine and azithromycin. By Day 5 of his admission, he improved significantly and was extubated and downgraded from the ICU to the medical floor, pending discharge. This case report provides anecdotal evidence for the effectiveness of the hydroxychloroquine and azithromycin combination currently being used across the nation to manage COVID-19, pending development of a definitive vaccine or antiviral treatment.
一名74岁男性因2019冠状病毒病（COVID-19）病毒性肺炎继发急性呼吸衰竭，被收入纽约州立大学下州医学中心重症监护病房（ICU）。该患者有多种严重合并症，包括肺癌和食管癌切除术后病史、伴有神经功能缺损的脑血管意外、糖尿病、高血压和外周血管疾病。患者入院时处于感染性休克和呼吸衰竭状态，需要插管和机械通气。胸部计算机断层扫描（CT）显示双侧斑片状混浊，怀疑为病毒性肺炎，送往纽约州卫生部的COVID-19痰液样本检测呈阳性。该患者的合并症以及年龄，使他处于COVID-19死亡风险最高的类别。患者接受了羟氯喹和阿奇霉素的药物治疗。入院第5天，他明显好转，拔除气管插管，从ICU转至普通病房，等待出院。本病例报告为目前在全国范围内用于治疗COVID-19的羟氯喹和阿奇霉素联合用药的有效性提供了实例证据，直至确定的疫苗或抗病毒治疗方法出现。
