Mild pneumonia with radiological worsening in a patient with a SARS-CoV-2 (COVID-19) infection
Keywords:
SARS-CoV-2, fever, pneumoniaAbstract
Introduction: Mild pneumonia, in SARS-CoV-2 infection, usually shows with symptoms such as fever, cough, malaise, or none (asymptomatic); positive chest radiographs can be detected with no signs of severity.
Objective: To describe the clinical, humoral and imaging characteristics of a patient with mild pneumonia and radiological worsening in the course of SARS-CoV-2 (COVID-19) infection, treatment used and evolution.
Clinical case: A 56-year-old case is reported with history of arterial hypertension and congenital retinopathy. He was in an isolation center in Cuba, he had a fever of 38 ° C and abdominal pain. He was taken to the e,ergency room at Doctor León Cuervo Rubio Clinical Surgical Teaching Provincial Hospital. He was assessed, and complementary studied were indicated. The patient received medical treatment. He was admitted on suspicion of SARS-CoV-2 (COVID-19) infection. Subsequently, he was confirmed positive for infection by real-time PCR and treatment was started. In the following days, chest X-ray was performed and the presence of inflammatory lesions in the lung was verified, for which a mild pneumonia was diagnosed in the course of COVID-19 and antimicrobial treatment started. The patient did not improve in the following days and evolutionary X-ray was performed which revealed he had radiological worsening. He was transferred to the intensive care unit with the diagnosis of severe pneumonia in the course of COVID-19. After several days of treatment in the service, the patient showed clinical improvement confirmed by evolutionary X-ray. The patient was discharged from the clinic.
Conclusions: Patients with mild pneumonia, in the course of infection by SARS-CoV-2 (COVID-19), may present radiological worsening, for which they require admission to an intensive care unit. In the case reported here, favorable evolution resulted after several days of treatment in the intensive care unit.
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References
1. García Zacarías J, Pérez Rodríguez M, Bender del Busto JE. Covid-19. Manifestaciones neurológicas. Gac Méd Espirit. 2020 Abr [citado: 07/09/2020];22(1):1-6. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1608-89212020000100001&lng=es
2. Guzmán del Giudice OE, Lucchesi Vásquez EP, Trelles De Belaúnde M, Pinedo Gonzales RH, Camere Torrealva MA, Daly A, et al. Características clínicas y epidemiológicas de 25 casos de COVID-19 atendidos en la Clínica Delgado de Lima. Rev Soc Peru Med Interna. 2020 [citado: 14/08/2020];33(1). Disponible en: http://revistamedicinainterna.net/index.php/spmi/article/view/506
3. Pérez Abereu MR, Gómez Tejeda JJ, Diéguez Guach RA. Características clínico-epidemiológicas de la COVID-19. Revista Habanera de Ciencias Médicas. 2020 [citado: 07/09/2020];19(2). Disponible en: http://www.revhabanera.sld.cu/index.php/rhab/article/view/3254
4. Serra Valdés MÁ. Infección respiratoria aguda por COVID-19: una amenaza evidente. Rev haban cienc méd. 2020 Feb [citado: 07/09/2020];19(1):1-5. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1729-519X2020000100001&lng=es
5. Pan Y, Guan H, Zhou S, Wang Y, Li Q, Zhu T, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. European Radiology. 2020;30(6):3306-9. Disponible en: https://doi.org/10.1007/s00330-020-06731-x
6. Escobar G, Matta J, Ayala R, Amado J. Características clínico epidemiológicas de pacientes fallecidos por covid-19 en un hospital nacional de Lima, Perú. Rev. Fac. Med. Hum. 2020 Abr [citado: 07/09/2020];20(2):180-5. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S2308-05312020000200180&lng=es.http://dx.doi.org/10.25176/rfmh.v20i2.2940
7. Huaroto F, Reyes N, Huamán K, Bonilla C, Curisinche Rojas M, Carmona G, et al. Intervenciones farmacológicas para el tratamiento de la Enfermedad por Coronavirus (COVID-19). An. Fac. med. 2020 Mar [citado: 05/09/2020];81(1):71-9. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1025-55832020000100071&lng=es. http://dx.doi.org/10.15381/anales.v81i1.17686
8. Xu X, Yu C, Qu J, Zhang L, Jiang S, Huang D, et al. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2. Eur J Nucl Med Mol Imaging. 2020;47(5):1275-80. Disponible en: https://doi.org/10.1007/s00259-020-04735-9
9. Chen X, Liu S, Zhang C, Pu G, Sun J, Shen J, et al. Dynamic Chest CT Evaluation in Three Cases of 2019 Novel Coronavirus Pneumonia. Arch Iran Med. 2020;23(4):277-80. Disponible en: https://doi.org/10.34172/aim.2020.11
10. Chin TW, Lo C, Lui MM, Lee J, Chiu KW, Chung TW, et al. Frequency and Distribution of Chest Radiographic Findings in Patients Positive for COVID-19. Radiology. 2020;296(2):7278. Disponible en: https://doi.org/10.1148/radiol.2020201160.
