Clinical characteristics, diagnosis and treatment of COVID-19: A case report

  Objective  To explore the clinical characteristics, diagnosis and treatment of Coronavirus Disease 2019 (COVID-19), and provide evidence for its clinical diagnosis and treatment.

  Methods  The patient was a 42 year-old male with COVID-19, who was admitted to Hankou Hospital on January 22, 2020. On February 4, he was transferred to Huoshenshan Hospital, and then was successfully cured and discharged on February 9. The clinical characteristics of the patient was analyzed, and the clinical diagnosis and treatment experience was summarized.

  Results  The patient was a medical worker in Wuhan who had been exposed to fever patients many times before the onset of the disease. The main clinical symptoms were dry cough, fatigue and fever, with fever appearing later than dry cough and fatigue. On the day of admission, the total number of leukocytes in peripheral blood was normal, lymphocyte count decreased, the hypersensitive c-reactive protein (hsCRP) increased, and the procalcitonin was normal. Throat swab tested positive for nucleic acid of 2019-nCoV virus. In the early stage, the chest CT showed that there were multiple ground glass shadows in bilateral lungs, the pathological changes were mainly distributed subpleurally and perpherally. From the 4th day of admission, the patient's condition gradually worsened, with increased respiratory rate and body temperature, and the peripheral blood lymphocyte decreased progressively. On the 8th day of admission, the patient's highest temperature was 40.7℃, and the oxygen saturation (SpO₂) was 83% under the condition of high flow oxygen inhalation. The chest CT findings showed that the virus progressed rapidly, the number of lesions increased significantly with expanded scope and increased density. The distribution of lesions advanced from peripheral to central. In addition to the treatment of air isolation, nasal catheter oxygen inhalation and symptomatic support, antiviral drugs were used throughout the treatment. On January 22, oseltamivir phosphate capsule was given orally (75 mg, 2 times per day) for 6 days; On January 24, 3 tablets of Lopinavir and Ritonavir Tablets were administered orally (2 times per day) for 6 days; Then, Arbidol Tablet, 0.2 g (2 tablets) were administered orally (3 times per day) for 5 days. In severe stage, methylprednisolone was given (40 mg) once per 12 h, intravenous infusion of immunoglobulin (20g) once per day, and subcutaneous injection of Thymosin (1.6 mg) once per day. On February 2, the symptoms were relieved, various indicators were improved, and the pulmonary lesion was obviously absorbed. The results of throat swab on February 4th and 9th were negative for 2019-nCoV nucleic acid test. After 19 days' hospitalization, the patient was cured and discharged.

  Conclusion  The COVID-19 in young adults can be cured by active treatment.