A Patient with COVID-19 Disease in a Referral Hospital in Iran: A Typical Case

Author(s): Fereshteh Ghiasvand, Sepideh Zahak Miandoab, Hamid Harandi, Fereshteh Shahmari Golestan, Seyed Ahmad Seyed Alinaghi*

Journal Name: Infectious Disorders - Drug Targets
Formerly Current Drug Targets - Infectious Disorders

Volume 20 , Issue 4 , 2020


Become EABM
Become Reviewer
Call for Editor

Abstract:

After the initial outbreak of the new Coronavirus in Wuhan at the end of December 2019, many new cases were reported in other provinces of China and also many other countries over the world, including South Korea, Italy, Iran, Japan, and 68 other countries. We present a case report of a 61-year-old woman with a history of diabetes mellitus who was referred to the emergency department of a referral hospital in Tehran, Iran. The patient presented with fever, chills, and myalgia within three days. Laboratory analysis showed increased levels of erythrocyte sedimentation rate (ESR), and mild leukopenia. SARS-CoV-2 PCR test –under the Iran Ministry of Health and Medical Education (MoH&ME) guidelines– was conducted and the result was positive. The chest X-ray showed bilateral ground-glass opacity. O2 saturation was 87% (without O2 therapy). The patient was hospitalized and treated with Oseltamivir 75 mg every 12 hours, Lopinavir/Ritonavir (Kaletra) 400/100 mg every 12 hours and hydroxychloroquine 400 mg stat. The patient's last O2 saturation measured was 93% and she had no fever on the 10th day of hospitalization. Therefore, she was discharged from hospital and quarantined at home according to the Iran Ministry of Health protocol.

Keywords: Coronavirus, COVID-19, diabetes mellitus, ground glass Opacity, SARS-CoV-2 PCR test, severe acute respiratory syndrome coronavirus 2.

[1]
Lu, H.; Stratton, C.W.; Tang, Y.W. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J. Med. Virol., 2020, 92(4), 401-402.
[http://dx.doi.org/10.1002/jmv.25678] [PMID: 31950516]
[2]
Huang, C.; Wang, Y.; Li, X.; Ren, L.; Zhao, J.; Hu, Y.; Zhang, L.; Fan, G.; Xu, J.; Gu, X.; Cheng, Z.; Yu, T.; Xia, J.; Wei, Y.; Wu, W.; Xie, X.; Yin, W.; Li, H.; Liu, M.; Xiao, Y.; Gao, H.; Guo, L.; Xie, J.; Wang, G.; Jiang, R.; Gao, Z.; Jin, Q.; Wang, J.; Cao, B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 2020, 395(10223), 497-506.
[http://dx.doi.org/10.1016/S0140-6736(20)30183-5] [PMID: 31986264]
[3]
[4]
WHO. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)., 2020.https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov) Available from:
[5]
Chang, L.; Yan, Y.; Wang, L. Coronavirus Disease 2019: Coronaviruses and Blood Safety. Transfus. Med. Rev., 2020.S0887-7963(20)30014-6
[http://dx.doi.org/10.1016/j.tmrv.2020.02.003] [PMID: 32107119]
[6]
WHO; Coronavirus disease 2019 (COVID-19) Situation Report – 43., 2020 03 march. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200303-sitrep-43-covid-19.pdf?sfvrsn=2c21c09c_2 Available from:
[7]
organization, W.h. Coronavirus disease 2019 (COVID-19) Situation Report – 74., 2020 3 April. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200403-sitrep-74-covid-19-mp.pdf?sfvrsn=4e043d03_12 Available from:
[8]
organization, W.h. Coronavirus disease 2019 (COVID-19) Situation Report – 31., 2020 20February;. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200220-sitrep-31-covid-19.pdf?sfvrsn=dfd11d24_2 Available from:
[9]
organization, W.h. Diagnostic detection of Wuhan coronavirus 2019 by real-time RTPCR., 2020 13Jan;. https://www.who.int/docs/default-source/coronaviruse/wuhan-virus-assay-v1991527e5122341d99287a1b17c111902.pdf?sfvrsn=d381fc88_2 Available from:
[10]
Mégarbane, B. Chloroquine and hydroxychloroquine to treat COVID-19: between hope and caution. Clin. Toxicol. (Phila.), 2020, 1-2.
[http://dx.doi.org/10.1080/15563650.2020.1748194] [PMID: 32237918]
[11]
Kim, A.H.J.; Sparks, J.A.; Liew, J.W.; Putman, M.S.; Berenbaum, F.; Duarte-García, A.; Graef, E.R.; Korsten, P.; Sattui, S.E.; Sirotich, E.; Ugarte-Gil, M.F.; Webb, K.; Grainger, R. COVID-19 Global Rheumatology Alliance†. A Rush to Judgment? Rapid Reporting and Dissemination of Results and Its Consequences Regarding the Use of Hydroxychloroquine for COVID-19. Ann. Intern. Med., 2020.
[http://dx.doi.org/10.7326/M20-1223] [PMID: 32227189]
[12]
Gautret, P.; Lagier, J.C.; Parola, P.; Hoang, V.T.; Meddeb, L.; Mailhe, M.; Doudier, B.; Courjon, J.; Giordanengo, V.; Vieira, V.E.; Dupont, H.T.; Honoré, S.; Colson, P.; Chabrière, E.; La Scola, B.; Rolain, J.M.; Brouqui, P.; Raoult, D. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int. J. Antimicrob. Agents, 2020.105949
[http://dx.doi.org/10.1016/j.ijantimicag.2020.105949] [PMID: 32205204]
[13]
Yao, T.T.; Qian, J.D.; Zhu, W.Y.; Wang, Y.; Wang, G.Q. A systematic review of lopinavir therapy for SARS coronavirus and MERS coronavirus-A possible reference for coronavirus disease-19 treatment option. J. Med. Virol., 2020.
[http://dx.doi.org/10.1002/jmv.25729] [PMID: 32104907]
[14]
Lim, J.; Jeon, S.; Shin, H.Y.; Kim, M.J.; Seong, Y.M.; Lee, W.J.; Choe, K.W.; Kang, Y.M.; Lee, B.; Park, S.J. Case of the Index Patient Who Caused Tertiary Transmission of COVID-19 Infection in Korea: the Application of Lopinavir/Ritonavir for the Treatment of COVID-19 Infected Pneumonia Monitored by Quantitative RT-PCR. J. Korean Med. Sci., 2020, 35(6)e79
[http://dx.doi.org/10.3346/jkms.2020.35.e79] [PMID: 32056407]
[15]
Zhou, D.; Dai, S.M.; Tong, Q. COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression. J. Antimicrob. Chemother., 2020.dkaa114
[http://dx.doi.org/10.1093/jac/dkaa114] [PMID: 32196083]
[16]
Lenzer, J. Covid-19: US gives emergency approval to hydroxychloroquine despite lack of evidence. BMJ, 2020, 369, m1335.
[http://dx.doi.org/10.1136/bmj.m1335] [PMID: 32238355]
[17]
Health, I.m.o Diagnosis and care of COVID 19 flowchart for outpatient and inpatient services; ; Health, I.m.o, Ed.;. , 2020. 9March
[18]
Ghaffarzadegan, N.; Rahmandad, H. Simulation-based Estimation of the Spread of COVID-19 in Iran. medRxiv, 2020.
[19]
WHO. Novel Coronavirus – China., 2020.https://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/ Available from:
[20]
Lai, C.C.; Shih, T.P.; Ko, W.C.; Tang, H.J.; Hsueh, P.R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int. J. Antimicrob. Agents, 2020, 55(3)105924
[http://dx.doi.org/10.1016/j.ijantimicag.2020.105924] [PMID: 32081636]
[21]
Chen, N.; Zhou, M.; Dong, X.; Qu, J.; Gong, F.; Han, Y.; Qiu, Y.; Wang, J.; Liu, Y.; Wei, Y.; Xia, J.; Yu, T.; Zhang, X.; Zhang, L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet, 2020, 395(10223), 507-513.
[http://dx.doi.org/10.1016/S0140-6736(20)30211-7] [PMID: 32007143]
[22]
Yang, W.; Cao, Q.; Qin, L.; Wang, X.; Cheng, Z.; Pan, A.; Dai, J.; Sun, Q.; Zhao, F.; Qu, J.; Yan, F. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China. J. Infect., 2020, 80(4), 388-393.
[http://dx.doi.org/10.1016/j.jinf.2020.02.016] [PMID: 32112884]
[23]
Deng, S.Q.; Peng, H.J. Characteristics of and Public Health Responses to the Coronavirus Disease 2019 Outbreak in China. J. Clin. Med., 2020, 9(2)E575
[http://dx.doi.org/10.3390/jcm9020575] [PMID: 32093211]
[24]
Shi, H.; Han, X.; Jiang, N.; Cao, Y.; Alwalid, O.; Gu, J.; Fan, Y.; Zheng, C. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect. Dis., 2020, 20(4), 425-434.
[http://dx.doi.org/10.1016/S1473-3099(20)30086-4] [PMID: 32105637]
[25]
Wei, J. Novel Coronavirus (COVID-19) Pneumonia: Serial Computed Tomography Findings. Korean J. Radiol., 2019, 2020.
[PMID: 32100486]
[26]
Zhang, J.J. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy, 2020.


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 20
ISSUE: 4
Year: 2020
Published on: 15 October, 2020
Page: [559 - 562]
Pages: 4
DOI: 10.2174/1871526520666200429115535
Price: $65

Article Metrics

PDF: 33
HTML: 1