Recovery from critical covid-19 despite delays in diagnosis and respiratory treatment: A cautionary tale
Although an acute, usually self-resolving disease, COVID-19 can also be deadly. Thus far, no approved specific treatments for this novel highly contagious disease are available, which posed great challenges on clinicians worldwide. Here we present the case of a relatively young COVID-19 patient who recovered well, despite delayed diagnosis and initiation of aggressive treatment. From the case, we speculated that: (a) Delayed diagnosis may miss the optimal antiviral treatment period for severe cases. (b) Monitoring of inflammatory markers and blood gas analysis in early stage may assist in identifying high-risk patients. (c) Glucocorticoids therapy in early stage may be harmful to the patient. (d) Once progressed to ARDS, mechanical ventilatory support should be considered as soon as possible in case of refractory hypoxemia. (e) ECMO, a scarce medical resource, should not be abused to treat COVID-19 patients with very low expected survival rates, especially during the period when medical resources are run out. (f) convalescent plasma therapy should be initiated in earlier stage of disease.