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1例新型冠状病毒肺炎危重症超应答者的病例报告

A case report of super responder of critical COVID-19 pneumonia.

作者信息

Kishaba Tomoo, Maeda Akiko, Fukuoka Shou, Imai Toru, Takakura Shunichi, Yokoyama Shuhei, Shiiki Soichi, Narita Masashi, Nabeya Daijiro, Nagano Hiroaki

机构信息

Department of Respiratory Medicine, Okinawa Chubu Hospital, Japan.

Department of Internal medicine, Okinawa Chubu Hospital, Japan.

出版信息

J Med Invest. 2021;68(1.2):192-195. doi: 10.2152/jmi.68.192.

Abstract

This report presents a case of a 74-year-old man who showed dramatic therapeutic response to treatment of coronavirus infectious disease-19 (COVID-19) pneumonia. He reported four-day history of sustained fever and acute progressive dyspnea. He developed severe respiratory failure, underwent urgent endotracheal intubation and showed marked elevation of inflammatory and coagulation markers such as c-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH) and D-dimer. Chest computed tomography (CT) demonstrated diffuse consolidation and ground glass opacity (GGO). We diagnosed critical COVID-19 pneumonia with detailed sick contact history and naso-pharyngeal swab of a reverse-transcriptase-polymerase-chain reaction (RT-PCR) assay testing. He received anti-viral drug, anti-interleukin (IL-6) receptor antagonist and intravenous methylprednisolone. After commencing combined intensive therapy, he showed dramatic improvement of clinical condition, serum biomarkers and radiological findings. Early diagnosis and rapid critical care management may provide meaningful clinical benefit even if severe case. J. Med. Invest. 68 : 192-195, February, 2021.

摘要

本报告介绍了一例74岁男性患者,其对冠状病毒感染疾病19(COVID-19)肺炎的治疗表现出显著的治疗反应。他自述有持续发热和急性进行性呼吸困难的四天病史。他发展为严重呼吸衰竭,接受了紧急气管插管,并显示炎症和凝血指标如C反应蛋白(CRP)、铁蛋白、乳酸脱氢酶(LDH)和D-二聚体显著升高。胸部计算机断层扫描(CT)显示弥漫性实变和磨玻璃影(GGO)。通过详细的密切接触史和逆转录聚合酶链反应(RT-PCR)检测的鼻咽拭子,我们诊断为重症COVID-19肺炎。他接受了抗病毒药物、抗白细胞介素(IL-6)受体拮抗剂和静脉注射甲泼尼龙治疗。开始联合强化治疗后,他的临床状况、血清生物标志物和影像学表现有了显著改善。即使是重症病例,早期诊断和快速的重症监护管理也可能带来有意义的临床益处。《医学调查杂志》68: 192 - 195,2021年2月。

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