A case report of super responder of critical COVID-19 pneumonia

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  • Kishaba Tomoo
    Department of Respiratory Medicine, Okinawa Chubu Hospital, Japan
  • Maeda Akiko
    Department of Respiratory Medicine, Okinawa Chubu Hospital, Japan
  • Fukuoka Shou
    Department of Internal medicine, Okinawa Chubu Hospital, Japan
  • Imai Toru
    Department of Internal medicine, Okinawa Chubu Hospital, Japan
  • Takakura Shunichi
    Department of Infectious Disease, Okinawa Chubu Hospital, Japan
  • Yokoyama Shuhei
    Department of Infectious Disease, Okinawa Chubu Hospital, Japan
  • Shiiki Soichi
    Department of Infectious Disease, Okinawa Chubu Hospital, Japan
  • Narita Masashi
    Department of Infectious Disease, Okinawa Chubu Hospital, Japan
  • Nabeya Daijiro
    Department of Respiratory Medicine, Okinawa Chubu Hospital, Japan
  • Nagano Hiroaki
    Department of Respiratory Medicine, Okinawa Chubu Hospital, Japan

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<p>This report presents a case of a 74-year-old man who showed dramatic therapeutic response to treatment of coronavirus infectious disease-19 (COVID-19) pneumonia. He reported four-day history of sustained fever and acute progressive dyspnea. He developed severe respiratory failure, underwent urgent endotracheal intubation and showed marked elevation of inflammatory and coagulation markers such as c-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH) and D-dimer. Chest computed tomography (CT) demonstrated diffuse consolidation and ground glass opacity (GGO). We diagnosed critical COVID-19 pneumonia with detailed sick contact history and naso-pharyngeal swab of a reverse-transcriptase-polymerase-chain reaction (RT-PCR) assay testing. He received anti-viral drug, anti-interleukin (IL-6) receptor antagonist and intravenous methylprednisolone. After commencing combined intensive therapy, he showed dramatic improvement of clinical condition, serum biomarkers and radiological findings. Early diagnosis and rapid critical care management may provide meaningful clinical benefit even if severe case. J. Med. Invest. 68 : 192-195, February, 2021</p>

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