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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
COVID-19 managed with early non-invasive ventilation and a bundle pharmacotherapy: A case report
Mian Peng, Di Ren, Xue-Yan Liu, Jin-Xiu Li, Rong-Lin Chen, Bao-Jun Yu, Yong-Feng Liu, Xi Meng, Yan-Si Lyu
Mian Peng, Department of Intensive Care Unit, the Third Affiliated Hospital of Shenzhen University, Shenzhen 518001, Guangdong Province, China
Di Ren, Department of Intensive Care Unit, the Second People’s Hospital of Shenzhen, Shenzhen 518001, Guangdong Province, China
Xue-Yan Liu, Department of Intensive Care Unit, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, the Second Affiliated Hospital of Jinan University, Shenzhen 518020, Guangdong Province, China
Jin-Xiu Li, Xi Meng, Department of Intensive Care Unit, the Third People’s Hospital of Shenzhen, Shenzhen 518001, Guangdong Province, China
Rong-Lin Chen, Yong-Feng Liu, Department of Intensive Care Unit, Shenzhen Longgang Central Hospital, Shenzhen 518001, Guangdong Province, China
Bao-Jun Yu, Department of Intensive Care Unit, Shenzhen Baoan District People’s Hospital, Shenzhen 518001, Guangdong Province, China
Yan-Si Lyu, Department of Dermatology, Shenzhen University General Hospital, Shenzhen 518067, Guangdong Province, China
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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: Xue-Yan Liu, PhD, Professor, Department of Intensive Care Unit, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, the Second Affiliated Hospital of Jinan University, Dongmen North Road No.1017, Luohu District, Shenzhen 518020, Guangdong Province, China. liuxueyan100916@163.com
Received: March 11, 2020
Peer-review started: March 11, 2020
First decision: April 1, 2020
Revised: April 9, 2020
Accepted: April 17, 2020
Article in press: April 17, 2020
Published online: May 6, 2020
BACKGROUND
The coronavirus disease 2019 (COVID-19) pandemic has become an immense public health burden, first in China and subsequently worldwide. Developing effective control measures for COVID-19, especially measures that can halt the worsening of severe cases to a critical status is of urgent importance.
CASE SUMMARY
A 52-year-old woman presented with a high fever (38.8 °C), chills, dizziness, and weakness. Epidemiologically, she had not been to Wuhan where COVID-19 emerged and did not have a family history of a disease cluster. A blood test yielded a white blood cell count of 4.41 × 109/L (60.6 ± 2.67% neutrophils and 30.4 ± 1.34% lymphocytes). Chest imaging revealed bilateral ground-glass lung changes. Based on a positive nasopharyngeal swab nucleic acid test result and clinical characteristics, the patient was diagnosed with COVID-19. Following treatment with early non-invasive ventilation and a bundle pharmacotherapy, she recovered with a good outcome.
CONCLUSION
Early non-invasive ventilation with a bundle pharmacotherapy may be an effective treatment regimen for the broader population of patients with COVID-19.
Core tip: The coronavirus disease 2019 (COVID-19) outbreak has become a public health emergency of international concern. Establishing effective control measures is of urgent importance. We here report a case of severe COVID-19. The patient was treated successfully with early non-invasive ventilation when her arterial oxygen partial pressure/fractional inspired oxygen ratio dropped below 200 mmHg, and a bundle pharmacotherapy which included an antiviral cocktail (lopinavir/ritonavir plus α-interferon), an immunity enhancer (thymosin), a corticosteroid to reduce pulmonary exudation (methylprednisolone), a traditional Chinese medicine-derived anti-inflammatory prescription (Xuebijing), and an anti-coagulant to prevent deep vein thrombosis (heparin). Early non-invasive ventilation with a bundle pharmacotherapy may be an effective regimen for patients with COVID-19.
