For my medical colleagues,
I would like to share with you a case of COVID 19 that im personally happy with…
45 yo. M, known HTN
Referred to us as a positive COVID,
Was distressed upon admission, desaturated and intubated
Saturation and PO2 remained low on MV and on high PEEP and high FIO2
His lab showed evidence of cytokine storm with acute kidney injury and acute renal shutdown, severe sepsis, severe lymphopenia…
All his lab was going downhill
And was discovered to be diabetic, HBA1C 11%
ECHO done: severe LV systolic dysfunction, elevated PCWP, dilated IVC, B lines diffusely in lung ultrasound
I personally could not decide this is a chronic Ischemic cardiomyopathy or acute myocarditis related to COVID which was a possible option in the presence of this severe cytokine storm
Started levo with dobu and lasix
For COVID 19 we started:
Favipravir
Lopinavir + ritonavir
Hydroxych.quine plus azithromycin despite his baseline QTc was 455 and Tisdale score was 12 (high tisk), but we kept eye on his QTc and luckily it did not increase
Prophylactic heparin
Then added
Umbrella of AB (Linezolid, meropenom)
Plus other supportive TTT
After starting dobu, UOP improved significantly, then on the following days of the treatment everything improved,
We were able to wean his vasopressor and inotropic support
Then his follow up CT showed real regression of his pneumonia and CXR is improved…
Today we finally extubated him successfully, he is maintaining Sat of 99% on non rebreathing mask, and regaining his conscious level…
We dont know yet what exactly helped his COVID pneumonia to improve and the cytokine storm to settle down because we hit him with everything, but the common observations i had from all my patients now are:
Favipravir is good
High HBA1c is bad
The bottomline is he is recovering now and was so close to pass away! He is a father of a very young daughter and a young man.
I would like to thank all my team especially dr. Nadeem Javid, MartinKurian, Ajith Cherian Thomas, Foad Ahmed for their great effort and knowledge!
His CXR and CT chest before and now are attached as well his ECHO and lung ultrasound are attachedFor my medical colleagues,
I would like to share with you a case of COVID 19 that im personally happy with…
45 yo. M, known HTN
Referred to us as a positive COVID,
Was distressed upon admission, desaturated and intubated
Saturation and PO2 remained low on MV and on high PEEP and high FIO2
His lab showed evidence of cytokine storm with acute kidney injury and acute renal shutdown, severe sepsis, severe lymphopenia…
All his lab was going downhill
And was discovered to be diabetic, HBA1C 11%
ECHO done: severe LV systolic dysfunction, elevated PCWP, dilated IVC, B lines diffusely in lung ultrasound
I personally could not decide this is a chronic Ischemic cardiomyopathy or acute myocarditis related to COVID which was a possible option in the presence of this severe cytokine storm
Started levo with dobu and lasix
For COVID 19 we started:
Favipravir
Lopinavir + ritonavir
Hydroxych.quine plus azithromycin despite his baseline QTc was 455 and Tisdale score was 12 (high tisk), but we kept eye on his QTc and luckily it did not increase
Prophylactic heparin
Then added
Umbrella of AB (Linezolid, meropenom)
Plus other supportive TTT
After starting dobu, UOP improved significantly, then on the following days of the treatment everything improved,
We were able to wean his vasopressor and inotropic support
Then his follow up CT showed real regression of his pneumonia and CXR is improved…
Today we finally extubated him successfully, he is maintaining Sat of 99% on non rebreathing mask, and regaining his conscious level…
We dont know yet what exactly helped his COVID pneumonia to improve and the cytokine storm to settle down because we hit him with everything, but the common observations i had from all my patients now are:
Favipravir is good
High HBA1c is bad
The bottomline is he is recovering now and was so close to pass away! He is a father of a very young daughter and a young man.
I would like to thank all my team especially dr. Nadeem Javid, MartinKurian, Ajith Cherian Thomas, Foad Ahmed for their great effort and knowledge!
His CXR and CT chest before and now are attached as well his ECHO and lung ultrasound are attached