Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3903
Peer-review started: March 28, 2020
First decision: July 3, 2020
Revised: July 9, 2020
Accepted: July 30, 2020
Article in press: July 30, 2020
Published online: September 6, 2020
In December 2019, the first patient with 2019-novel coronavirus (2019-nCoV) was reported in Wuhan, China, and the disease spread rapidly across the country and surrounding countries within 2 mo. As of February 29, 2020, a total of 91 confirmed cases had been reported in Gansu Province. This case report of the diagnosis and treatment of an elderly patient with 2019-nCoV pneumonia complicated by acute exacerbation of chronic obstructive pulmonary disease in Gansu Province aims to provide a better reference for the treatment of patients in the future.
The patient, a 94-year-old female, lived in Maiji District of Tianshui, Gansu Province, China. On January 30, 2020, she was admitted to the Fourth People’s Hospital of Tianshui after 9 d of close contact with a patient with 2019-nCoV pneumonia. She was subsequently admitted to Gansu Provincial Hospital of Traditional Chinese Medicine for isolation and transferred to Tianshui Gansu Provincial Hospital of Infectious Diseases on February 3, 2020 for treatment. Upon initial examination, her body temperature was 36.7 °C , pulse was 80, breathing was 20, and blood pressure was 130/80 mmHg. She was conscious with normal development and normal nutrition. The pharynx was not red, and bilateral tonsils were not red and swollen. The lungs sounded slightly coarse with no dry or wet rales. The first symptoms were cough and fatigue on 2 February. The patient was hospitalized for 12 d. After active treatment, she was discharged on February 14 with a good prognosis.
A history of exposure to the affected area or patient is a major cause of 2019-nCoV infection, and population clustering is a high risk factor for transmission. Patients may not necessarily have respiratory system symptoms as the only clinical manifestation but may also have concomitant or first onset digestive symptoms. Attention should be paid to the prevention and treatment of multiple organ dysfunction syndrome. Nucleic acid testing is extremely important and needs to be repeated several times. Laboratory and auxiliary examination indicators during the first week of admission are extremely important. It is feasible to carry out dynamic and continuous index monitoring, which can predict and guide the prevention and treatment of multiple organ dysfunction and the prognosis of the disease.
Core tip: The 2019-novel coronavirus (nCoV) pneumonia, which is caused by a 2019-nCoV infection, is characterized by fever, weakness, and a dry cough. Severe cases can progress rapidly to acute respiratory distress syndrome, septic shock, and refractory metabolic acidosis. In this article, we describe a 94-year-old woman in Gansu province with an epidemiological history of cumulative exposure who was diagnosed with 2019-nCoV pneumonia during isolation and later presented with symptoms of cough and weakness. Acute exacerbation of chronic obstructive pulmonary disease was complicated during hospitalization. It was a severe case. After 12 d of active treatment, the patient was cured and discharged.