Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2020; 8(23): 6181-6189
Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.6181
Symptomatic and optimal supportive care of critical COVID-19: A case report and literature review
Qi-Lin Pang, Wen-Cheng He, Jin-Xiu Li, Lei Huang
Qi-Lin Pang, Jin-Xiu Li, Department of Intensive Care Unit, The Third People’s Hospital of Shenzhen, Shenzhen 518020, Guangdong Province, China
Wen-Cheng He, Lei Huang, Department of Intensive Care Unit, Peking University Shenzhen Hospital, Shenzhen 518000, Guangdong Province, China
Author contributions: Pang QL and Huang L collected the clinical data; Pang QL, He WC, and Huang L wrote the manuscript; Li JX and Huang L were responsible for the integrity and accuracy of the data and were the guarantors; Pang QL and He WC contributed equally to this work and should be regarded as co-first authors; all authors read and approved the final manuscript.
Supported by the Health and Family Planning Commission of Shenzhen Municipality, No. SZLY2018024; and Sanming Project of Medicine in Shenzhen, No. SZSM201512031.
Informed consent statement: Informed written consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lei Huang, MD, Chief Doctor, Department of Intensive Care Unit, Peking University Shenzhen Hospital, No. 1120 Lianhua Road, Futian District, Shenzhen 518000, Guangdong Province, China. hl0248@outlook.com
Received: August 7, 2020
Peer-review started: August 7, 2020
First decision: August 22, 2020
Revised: August 29, 2020
Accepted: September 25, 2020
Article in press: September 25, 2020
Published online: December 6, 2020
Processing time: 119 Days and 3.2 Hours
Abstract
BACKGROUND

Coronavirus disease 2019 (COVID-19) severity is classified as asymptomatic, mild, moderate, severe, and critical. Mild cases account for a large percentage of cases in the epidemic and typically exhibit a favorable prognosis. However, a 49%-67% mortality is noted in critical cases. No COVID-19-specific drug has been reported to date, and symptomatic and optimal supportive care, including oxygenation, anti-coinfection treatments, and ventilation, represent the mainstay of treatment for this disease, especially in critical patients.

CASE SUMMARY

In the above-mentioned context, we share our experience with the treatment of one critical COVID-19 case and review the relevant literature.

CONCLUSION

Timely tracheal intubation, reasonable mechanical ventilation support, appropriate anti-infection treatment, and early anticoagulation and immunity support are key factors in the successful treatment of this case.

Keywords: COVID-19; Critical case; Supportive treatment; Mechanical ventilation support; Case report; Literature review

Core Tip: The mortality of severe coronavirus disease 2019 (COVID-19) patients is high, and no effective antiviral drugs are available now. Therefore, it is important to identify a suitable treatment strategy that is associated with improved prognosis of COVID-19, especially in critically ill patients. Here, we share our experience with the treatment of one critical COVID-19 case. We conclude that timely intubation, reasonable mechanical ventilation support, appropriate anti-infection treatment, early anticoagulation and immune support, and other comprehensive measures may help to reduce the course of disease and patient mortality.