COVID-19 with Rapid Progression to Hypoxemia Likely due to Imbalance between Ventilation and Blood Flow: A Case Report.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2022-02-04 eCollection Date: 2022-01-01 DOI:10.1177/11795484211073273

Nobuyuki Koriyama, Akihiro Moriuchi, Kensaku Higashi, Tetsuro Kataoka, Takuro Arimizu, Go Takaguchi, Hideki Matsuoka, Maki Otsuka

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引用次数: 4

Abstract

Background: In COVID-19 pneumonia, cases of severe hypoxemia in the early stage and cases of sudden deterioration in respiratory status due to silent hypoxia leading to death, have been reported.

Case summary: A 70-year-old Japanese man with essential hypertension, dyslipidemia, chronic kidney disease and emphysema was hospitalized with the novel coronavirus disease. He had hypoxemia that was disproportionate to the severity of pneumonia indicated by computed tomography (CT), along with coagulation abnormalities. We speculated that there was a high possibility that he had developed ventilation and blood flow imbalance due to pulmonary intravascular coagulopathy (PIC) or hypoxic pulmonary vasoconstriction (HPV). In this case, early, short-term combination therapy with remdesivir, nafamostat mesylate and low-dose dexamethasone (Dex) was successful.

Conclusion: In COVID-19 patients with multiple comorbidities who have hypoxemia and coagulation abnormalities that are disproportionate to the severity of pneumonia on CT, it is important to commence antiviral and anticoagulant therapy as soon as possible, followed by use of a low dose of Dex.

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COVID-19快速发展为低氧血症可能是由于通气和血流不平衡:1例报告。

背景:在COVID-19肺炎中，已经报道了早期严重低氧血症和由于无症状缺氧导致呼吸状态突然恶化导致死亡的病例。病例总结:一名70岁的日本男性，患有原发性高血压、血脂异常、慢性肾病和肺气肿，因新型冠状病毒病住院治疗。他有低氧血症，与计算机断层扫描(CT)显示的肺炎严重程度不成比例，并伴有凝血异常。我们推测，由于肺血管内凝血功能障碍(PIC)或缺氧性肺血管收缩(HPV)，他很可能出现了通气和血流不平衡。在这种情况下，早期，短期联合治疗瑞德西韦，甲磺酸那莫他酯和低剂量地塞米松(Dex)是成功的。结论:对于具有多种合并症的COVID-19患者，如果CT显示低氧血症和凝血异常与肺炎严重程度不成比例，应尽早开始抗病毒和抗凝治疗，然后使用低剂量的右美托昔单抗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.