Waqas Khan Hafiz Muhammad, Parikh Niraj, Megala Shady Maher, Predeteanu George Silviu
Department of Cardiovascular Disease, McLaren-Flint/Michigan State University, Flint, MI, USA.
Department of Pulmonary and Critical Care, McLaren-Flint/Michigan State University, Flint, MI, USA.
Am J Case Rep. 2020 Jul 25;21:e925521. doi: 10.12659/AJCR.925521.
BACKGROUND Coronavirus disease 2019 (COVID-19) continues to spread, with confirmed cases now in more than 200 countries. Thus far there are no proven therapeutic options to treat COVID-19. We report a case of COVID-19 with acute respiratory distress syndrome who was treated with high-dose vitamin C infusion and was the first case to have early recovery from the disease at our institute. CASE REPORT A 74-year-old woman with no recent sick contacts or travel history presented with fever, cough, and shortness of breath. Her vital signs were normal except for oxygen saturation of 87% and bilateral rhonchi on lung auscultation. Chest radiography revealed air space opacity in the right upper lobe, suspicious for pneumonia. A nasopharyngeal swab for severe acute respiratory syndrome coronavirus-2 came back positive while the patient was in the airborne-isolation unit. Laboratory data showed lymphopenia and elevated lactate dehydrogenase, ferritin, and interleukin-6. The patient was initially started on oral hydroxychloroquine and azithromycin. On day 6, she developed ARDS and septic shock, for which mechanical ventilation and pressor support were started, along with infusion of high-dose intravenous vitamin C. The patient improved clinically and was able to be taken off mechanical ventilation within 5 days. CONCLUSIONS This report highlights the potential benefits of high-dose intravenous vitamin C in critically ill COVID-19 patients in terms of rapid recovery and shortened length of mechanical ventilation and ICU stay. Further studies will elaborate on the efficacy of intravenous vitamin C in critically ill COVID-19.
背景 2019 冠状病毒病（COVID - 19）持续传播，目前确诊病例已遍布200多个国家。迄今为止，尚无经证实的治疗COVID - 19的疗法。我们报告了一例患有急性呼吸窘迫综合征的COVID - 19病例，该患者接受了大剂量维生素C静脉输注治疗，是我院首例早期康复的病例。病例报告 一名74岁女性，近期无患病接触史及旅行史，出现发热、咳嗽和呼吸急促症状。除氧饱和度为87%以及肺部听诊有双侧啰音外，其生命体征正常。胸部X线检查显示右上叶有实变影，怀疑为肺炎。患者在空气隔离病房时，鼻咽拭子检测严重急性呼吸综合征冠状病毒2呈阳性。实验室数据显示淋巴细胞减少，乳酸脱氢酶、铁蛋白和白细胞介素 - 6升高。患者最初开始口服羟氯喹和阿奇霉素。第6天，她发展为急性呼吸窘迫综合征和感染性休克，为此开始进行机械通气和使用血管活性药物支持治疗，并静脉输注大剂量维生素C。患者临床症状改善，5天内能够脱离机械通气。结论 本报告强调了大剂量静脉注射维生素C对重症COVID - 19患者在快速康复、缩短机械通气时间和重症监护病房住院时间方面的潜在益处。进一步的研究将详细阐述静脉注射维生素C对重症COVID - 19患者的疗效。
