A case of severe COVID-19 pneumonia in a patient with obesity and diabetes treated by a non-pulmonary specialist team

DOI
  • Honjo Satoshi
    Department of Internal Medicine, TamaNanbu Chiiki Hospital
  • Chinen Naofumi
    Department of Internal Medicine, TamaNanbu Chiiki Hospital
  • Nunokawa Takahiro
    Department of Internal Medicine, TamaNanbu Chiiki Hospital
  • Muroya Yohei
    Department of Internal Medicine, TamaNanbu Chiiki Hospital Department of Internal Medicine, Chosei Hospital
  • Oshida Shigehito
    Department of Cardiology, TamaNanbu Chiiki Hospital Department of Cardiology, Chiba Prefectural Sawara Hospital
  • Setoguchi Masahiko
    Department of Cardiology, TamaNanbu Chiiki Hospital
  • Ogawa Toru
    Department of Cardiology, TamaNanbu Chiiki Hospital
  • Suzuki Ryoji
    Department of Internal Medicine, TamaNanbu Chiiki Hospital
  • Ono Yoshifumi
    Department of Internal Medicine, TamaNanbu Chiiki Hospital Department of General Internal Medicine, St Marianna University School of Medicine
  • Okuyama Ryuji
    Department of Palliative Care, TamaNanbu Chiiki Hospital
  • Yano Masataka
    Department of Urology, TamaNanbu Chiiki Hospital
  • Tachibana Shunichi
    Department of Internal Medicine, TamaNanbu Chiiki Hospital

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Other Title
  • 2020 年 4 月の第 1 波で，非専門医主体のチームで 救命しえた糖尿病・肥満合併重症 COVID-19 肺炎の 1 例

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Abstract

A 57-year-old male patient with diabetes and obesity was admitted to our hospital with complaints of fever in April 2020. His white blood cell count and C-reactive protein were 10500/μL and 17.4 mg/dL, respectively. His chest X-ray revealed a bilateral ground-glass opacity. The patient’s SARS-CoV-2 PCR test was positive;. hence, he was diagnosed with COVID-19. He needed 62 days of mechanical ventilation. Furthermore, he was administered numerous medications, including Favipiravir, Nafamostat Mesylate, methylprednisolone and antibiotics. He was discharged on day 82. Subsequently, he presented with the following clinical features;taste/olfactory disorders, joint pain, myalgia, and dyspnea. However, no clinical examination could explain those symptoms. When the initial COVID-19 wave shook Japan in April 2020, the TamaNanbu Chiiki Hospital had only one pulmonary specialist and no infectious disease expert. At that time, the availability of information and medical resources on COVID-19 was insufficient. A COVID-19 team including physicians primarily not from the department of respiratory medicine was assembled by our hospital. In this team, all physicians played their roles efficiently by using their general medicine skills. This case was epoch-making for showing the importance of physicians with general medicine skills during the COVID-19 crisis, which caused widespread problems for the Japanese medical system.

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