Department of Infectious Diseases, Tokyo Metropolitan Toshima Hospital, Japan.
Junior Resident Program, Tokyo Metropolitan Toshima Hospital, Japan.
Intern Med. 2021 Feb 1;60(3):479-485. doi: 10.2169/internalmedicine.4939-20. Epub 2020 Dec 22.
An outbreak of coronavirus disease 2019 (COVID-19) that began in Wuhan, China, has spread rapidly to many countries. We herein report four cases of COVID-19 confirmed in Japan among passengers of the cruise ship Diamond Princess and describe the clinical features, clinical course, and progression of chest computed tomographic images, chest radiographs, and treatment. Although these four patients had symptoms that included a fever, malaise, runny nose, and cough, one patient had no symptoms on admission. Two of the four patients needed mechanical ventilation due to respiratory deterioration. One of the patients who required mechanical ventilation was transferred to a higher-level medical institution. Except for that patient, the other three patients were able to return home under their own power. Every patient took lopinavir/ritonavir, which was considered the most effective treatment at the time. We used it after receiving approval from the ethics committee in our hospital. In this case report, we emphasize that some patients need to be carefully monitored, even if their respiratory condition is stable at the initial presentation, as their respiratory status may deteriorate rapidly within a few days after oxygen administration begins.
2019 年冠状病毒病（COVID-19）疫情在中国武汉暴发，迅速蔓延至许多国家。本文报告了日本 4 例在“钻石公主”号游轮上的乘客中确诊的 COVID-19 病例，并描述了他们的临床特征、临床病程以及胸部 CT 图像、胸片的变化和治疗经过。尽管这 4 名患者均有发热、乏力、流涕和咳嗽等症状，但有 1 名患者入院时无任何症状。这 4 名患者中有 2 名因呼吸恶化需要机械通气。需要机械通气的 1 名患者转至上级医疗机构。除该患者外，其他 3 名患者均能自行出院。所有患者均使用了洛匹那韦/利托那韦，这是当时被认为最有效的治疗药物。在获得我院伦理委员会批准后，我们使用了该药物。在本病例报告中，我们强调即使患者的呼吸状况在初始表现时稳定，也需要密切监测，因为他们的呼吸状况在开始吸氧后数天内可能迅速恶化。
