Volume 5, Issue 3, September 2020, Page: 74-80
Clinical Course of Five COVID-19 Patients and Treatment Updates
Mohsin Sheraz Mughal, Monmouth Medical Center, Long Branch, New Jersey, United States
Ikwinder Preet Kaur, Monmouth Medical Center, Long Branch, New Jersey, United States
Rameez Rehman, Monmouth Medical Center, Long Branch, New Jersey, United States
Hasan Mahmood Mirza, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, United States
Harjot Singh Jagdey, BronxCare Health System, Bronx, United States
Chandler Patton, Monmouth Medical Center, Long Branch, New Jersey, United States
Wael Ghali, Monmouth Medical Center, Long Branch, New Jersey, United States
Received: Jul. 10, 2020;       Accepted: Jul. 28, 2020;       Published: Aug. 20, 2020
DOI: 10.11648/j.ijidt.20200503.17      View  170      Downloads  69
Coronaviruses (CoVs) are enveloped, positive-sense RNA viruses. A novel coronavirus (nCoV) was discovered to be a cause of pneumonia outbreak in Wuhan, China in late 2019. The World Health Organization (WHO) named the disease as Coronavirus Disease 2019 (COVID-19) and declared it as a pandemic in March 2020. Since the detection of the first case of COVID-19 in the United States on January 20th, 2020 in Washington State, the pandemic is still expanding. As of July 8th, the United States (U.S.) has the maximum number (3.1 million) of confirmed COVID-19 patients. In this case series, we are presenting the clinical course of the first five confirmed COVID-19 cases admitted to a community hospital in the U.S. in the beginning of March 2020. We analyzed their clinical characteristics, pre-existing comorbidities, laboratory and radiological findings. The clinical management and outcomes are discussed alongside the literature review about current management options. In conclusion, primary management is supportive care to improve oxygenation by various methods. Safety and efficacy of treatment options including ramdesevir, IL-6 inhibitors and convalescent plasma have not yet been established and none of these is FDA approved so far. Increased age (>80 years), hypoxia at the time of presentation and pre-existing co-morbidities are likely related with poor outcomes.
Pneumonia, Coronavirus, Pandemic
To cite this article
Mohsin Sheraz Mughal, Ikwinder Preet Kaur, Rameez Rehman, Hasan Mahmood Mirza, Harjot Singh Jagdey, Chandler Patton, Wael Ghali, Clinical Course of Five COVID-19 Patients and Treatment Updates, International Journal of Infectious Diseases and Therapy. Vol. 5, No. 3, 2020, pp. 74-80. doi: 10.11648/j.ijidt.20200503.17
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The species severe acute respiratory syndrome-related coronavirus: Classifying 2019-nCoV and naming it SARS-Cov-2. (2020). Nature Microbiology, 5 (4), 536-544. https://doi.org/10.1038/s41564-020-0695-z.
"New Cases of COVID-19 In World Countries." Johns Hopkins Coronavirus Resource Center. Accessed July 10, 2020. https://coronavirus.jhu.edu/data/new-cases.
Verity, R., Okell, L. C., Dorigatti, I., Winskill, P., Whittaker, C., Imai, N., Cuomo-Dannenburg, G., Thompson, H., Walker, P. G., Fu, H., Dighe, A., Griffin, J. T., Baguelin, M., Bhatia, S., Boonyasiri, A., Cori, A., Cucunubá, Z., FitzJohn, R., Gaythorpe, K., Ferguson, N. M. (2020). Estimates of the severity of coronavirus disease 2019: A model-based analysis. The Lancet Infectious Diseases. https://doi.org/10.1016/s1473-3099(20)30243-7.
Omer, Saad B., Preeti Malani, and Carlos Del Rio. "The COVID-19 Pandemic in the US." JAMA, 2020. doi: 10.1001/jama.2020.5788.
Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., Wang, B., Xiang, H., Cheng, Z., Xiong, Y., Zhao, Y., Li, Y., Wang, X., & Peng, Z. (2020). Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA, 323 (11), 1061. https://doi.org/10.1001/jama.2020.1585.
World Health Organization. Coronavirus disease (COVID-19) technical guidance: Surveillance and case definitions. https://www.who.int/emergencies/diseases/novelcoronavirus-2019/technical-guidance/surveillance-and-case-definitions.
Chung, M., Bernheim, A., Mei, X., Zhang, N., Huang, M., Zeng, X., Cui, J., Xu, W., Yang, Y., Fayad, Z. A., Jacobi, A., Li, K., Li, S., & Shan, H. (2020). CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology, 295 (1), 202-207. https://doi.org/10.1148/radiol.2020200230.
Salehi, S., Abedi, A., Balakrishnan, S., & Gholamrezanezhad, A. (2020). Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. American Journal of Roentgenology, 1-7. https://doi.org/10.2214/ajr.20.23034.
Xie, X., Zhong, Z., Zhao, W., Zheng, C., Wang, F., & Liu, J. (2020). Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing. Radiology, 200343. https://doi.org/10.1148/radiol.2020200343.
Pan, F., Ye, T., Sun, P., Gui, S., Liang, B., Li, L., Zheng, D., Wang, J., Hesketh, R. L., Yang, L., & Zheng, C. (2020). Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. Radiology, 200370. https://doi.org/10.1148/radiol.202020037.
Wu, Zunyou, and Jennifer M. McGoogan. "Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China." JAMA 323, no. 13 (2020), 1239. doi: 10.1001/jama.2020.2648.
"Mortality Analyses." Johns Hopkins Coronavirus Resource Center. Accessed July 10, 2020. https://coronavirus.jhu.edu/data/mortality.
Onder, G., Rezza, G., & Brusaferro, S. (2020). Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. https://doi.org/10.1001/jama.2020.4683.
Wu, C., Chen, X., Cai, Y., Xia, J., Zhou, X., Xu, S., Huang, H., Zhang, L., Zhou, X., Du, C., Zhang, Y., Song, J., Wang, S., Chao, Y., Yang, Z., Xu, J., Zhou, X., Chen, D., Xiong, W. Song, Y. (2020). Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2020.0994.
Coronavirus disease 2019 (COVID-19). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html.
COVID-19 Treatment Guidelines. Last modified May 12, 2020. https://www.covid19treatmentguidelines.nih.gov/.
"The RECOVERY Trial: Dexamethasone for COVID-19?" REBEL EM - Emergency Medicine Blog. Last modified July 3, 2020. https://rebelem.com/the-recovery-trial-dexamethasone-for-covid-19/.
Browse journals by subject