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新型冠状病毒病 2019(COVID-19)合并人类免疫缺陷病毒(HIV)感染:护理经验的一例报告。

Coronavirus disease 2019 (COVID-19) complicated with human immunodeficiency virus (HIV) infection: a case report of nursing experience.

机构信息

Department of Respiratory Medicine, The First Affiliated Hospital of Air Force Medical University, Xi'an, China.

Department of Cardiovascular Medicine, Xijing Hospital, The First Affiliated Hospital of Air Force Military Medical University, Xi'an, China.

出版信息

Ann Palliat Med. 2022 Jan;11(1):378-383. doi: 10.21037/apm-21-2613.

Abstract

In this paper, we report a case of coronavirus disease 2019 (COVID-19) complicated with human immunodeficiency virus (HIV) infection. The 50-year-old male patient had unexplained "intermittent fever with sore throat" on February 9th, 2020. Chest computed tomography (CT) showed bilateral multiple patchy opacities and ground-glass opacities. A COVID-19 RNA test was positive. After admission, additional laboratory tests revealed the following: white blood cell (WBC) count, 4.7×109/L; neutrophil percentage, 85.1%; lymphocyte percentage, 12.3%; lymphocyte count, 0.59×109/L; hypersensitivity C-reactive protein, 5.52 mg/L; four coagulation factors, +; D-dimer, 1.32 mg/L; and procalcitonin, normal. He was HIV (+). The patient was diagnosed with COVID-19 complicated with HIV infection. The healthcare team administered symptomatic care, including nasal oxygen, oseltamivir, Lianhua Qingwen capsule, moxifloxacin, ribavirin, and thymus faxin, as well as nutritional support, mental care, diet and life management, and close monitoring. Moreover, the team implemented strict disinfection and quarantine and occupational protection. The patient's temperature returned to normal and sore throat significantly improved by day 10, and COVID-19 RNA tests were negative on February 19th, February 21st, and February 22nd. Reexamination by chest CT on February 22nd showed significant absorption of inflammation. After rounds by the chief physician and consultation with specialists, the patient was released from quarantine and discharged on February 23rd per the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 6). Patients with COVID-19 and HIV infection face both physical and mental challenges. More attention should be paid to nursing as we understand more about COVID-19. We hope to share our nursing experience through this case.

摘要

本文报告了 1 例新型冠状病毒病(COVID-19)合并人类免疫缺陷病毒(HIV)感染的病例。患者男性,50 岁,于 2020 年 2 月 9 日出现无明显诱因的“间断发热伴咽痛”,胸部 CT 显示双肺多发斑片及磨玻璃影。COVID-19 RNA 检测阳性。入院后进一步实验室检查示:白细胞计数 4.7×109/L,中性粒细胞比例 85.1%,淋巴细胞比例 12.3%,淋巴细胞计数 0.59×109/L,超敏 C 反应蛋白 5.52 mg/L,4 项凝血因子均异常,D-二聚体 1.32 mg/L,降钙素原正常。患者 HIV(+)。诊断为 COVID-19 合并 HIV 感染,给予对症治疗,包括鼻导管吸氧、奥司他韦、连花清瘟胶囊、莫西沙星、利巴韦林、胸腺法新,以及营养支持、心理疏导、饮食及生活管理、密切监测等。同时,实施严格的消毒隔离和职业防护。入院第 10 天患者体温恢复正常,咽痛明显改善,2 月 19 日、21 日、22 日 COVID-19 RNA 检测均阴性,2 月 22 日复查胸部 CT 炎症明显吸收。经主任查房和多学科会诊,患者符合解除隔离和出院标准,按《新型冠状病毒肺炎诊疗方案(试行第六版)》于 2 月 23 日出院。COVID-19 合并 HIV 感染患者面临身心双重挑战,随着对 COVID-19 认识的深入,护理工作需要更加关注。希望通过此病例分享护理经验。

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