General Surgery

Critical Case of COVID-19

 A 42 year old male patient presented to ED with two day history of fever and mild shortness of breath. 

No cough, no sore throat, no runny nose, no myalgia, no anosmia/hyposmia, no nausea or vomiting, no Abdo pain and no diarrhoea.

 He has no past medical history, not on any medications and is an Ex-Smoker.

 On examinations, he had high-grade fever and O2 Saturation of 91-92 on room air. Chest examinations revealed bibasal fine crepitations. Normal findings on CVS and abdominal examinations. 

Chest X-Ray show Cannon ball opacities in both lung fields. 

ABG shows T1RF.

 Basic Blood tests show Lymphocytopenia, raised inflammatory markers and stage 1 AKI.

 Patient was initially admitted to the ward but rapidly deteriorated and developed Haemoptysis and Severe Shortness of breath.

 CT CAP with contrast shows Classic COVID-19 infection with CT severe score. No other abnormalities in abdomen or pelvis.

 Nose and Throat swab tests are positive for COVID-19 four times.

 Full immunology, Rheumatology and Virology screen are all negative.

 Blood cultures did not show growth of any bacteria.

 How would you treat this patient?