Figure 1
A–E, consecutively: chest X-ray progression and follow-up image on first visit to outpatient clinic, Day 1, Day 9, Day 16 and Day 23 of hospitalisation.
Figure 2
CT scan of chest, taken on the 17th day of hospitalisation.
Table 1
Vital sign, symptoms and examination by day of illness and hospitalisation
| 1st Visit | Day 1 (admission) | Day 2 | Day 3 | Day 4 | Day 5 | Day 6 | Day 7 | Day 8 | Day 9 | Day 10 | Day 11 | Day 12 | Day 13 | Day 14 | Day 15 | Day 16 | Day 17 | Day 18 | Day 19 | Day 20 | Day 21 | Day 22 | Day 23 | Day 24 | Day 25 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cough | (+), dry | (+), dry | (+), dry | (+), dry | (+), dry | (+), dry | (+), dry | (+), dry | (+), dry | (+), dry | (+), dry | (+), dry | (+), dry | (+), dry | (+), dry | (+), dry | ± | ± | ± | ± | (−) | (±) | (+), dry | (+), dry | x | x |
| Dyspnoea | (−) | (+) | (+) | (+) | (+) | (+) | (+) | (+) | (+) | (+) | (+) | (+) | (+) | (+) | (+) | ± | ± | - | - | - | (−) | (−) | (+) | (+) | x | x |
| Fever | (−) | (−) | (−) | (−) | (−) | (−) | (−) | (−) | (−) | (−) | (−) | (−) | (−) | (−) | (−) | (−) | (+) | (−) | (+) | (−) | (−) | (+) | (+) | (+) | (+) | (+) |
| RR | 20 | 36 | 24 | 24 | 22 | 22 | 22 | 24 | 26 | 25 | 25 | 20 | 24 | 18 | 22 | 20 | 22 | 19 | 22 | 20 | 22 | 21 | 32 | 32 | 26 | 25 |
| SaO2 | 98% | 83% | 95% | 97% | 98% | 93% | 98% | 93% | 98% | 99% | 99% | 99% | 96% | 97% | 98% | 99% | 95% | 94% | 98% | 95% | 100% | 97% | 94% | 86% | 96% | 97% |
| Physical examination | (−) | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi ±/± | Rhonchi ±/± | Rhonchi ±/± | Rhonchi ±/± | Rhonchi ±/± | Rhonchi ±/± | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ | Rhonchi +/+ |
| Oxygenation | (−) | NRM 12 L/min | NRM 15 L/min | NRM 15 L/min | NRM 15 L/min | NRM 10 L/min | NIPPV 60 L/min | NIPPV 60 L/min | NIPPV 60 L/min | NIPPV 60 L/min | NIPPV 60 L/min | NIPPV 40 L/min | NRM 15 L/min | NRM 15 L/min | NRM 10 L/min | NRM 10 L/min | NC 3 L/min | NC 3 L/min | NC 3 L/min | NC 4 L/min | NC 2 L/min | NC 2 L/min | NRM 10 L/min | PC 15, PEEP 8, RR 20 FiO2 100% | PC 10, PEEP 8, RR 15 FiO2 90% | PC 15, PEEP 10, RR 30 FiO2 100% |
| Laboratory values | CBC Eos 0.0 (↓) CRP 43 (↑) | CBC Eos 0.1 (↓) Lym 11.6 (↓) Neut 80.9 (↑) CRP 40 (↑) Ur 36 Crea 1.2 (↑) eGFR 46.2 (↓) Glob 4.04 (↑) BilD 0.34 (↑) BilI 0.16 (↓) AST 104 (↑) ALT 74 (↑) GGT 187 (↑) LDH 1,054 (↑) Ferr 1,387.62 (↑) | FPG 212 (↑) PPG 243 (↑) RT-PCR NP (-) OP (-) (Result obtained on Day 8) | PPG 167 (↑) | ABG pH 7.45 pCO2 26.7 (↓) PaO2 75 (↓) HCO3 18.9 (↓) BE -3.50 SaO2 96.30 Temp 36.7 FiO2 ~100 | RT-PCR NP (-) (Result obtained on Day 17) | FPG 126 PPG 86 | FPG 516 (↑) PPG 309 (↑) | FPG 227 (↑) PPG 241 (↑) | FPG 339 (↑) PPG 170 (↑) | FPG 159 (↑) | FPG 321 (↑) PPG 53 (↑) | CBC Leu 13.71 (↑) Bas 0.2 (↓) Eos 0.0 (↓) Mon 4.5 (↓) Lym 3.6 (↓) Neut 91.7 (↑) | CRP 298 (↑) Proc 0.5 FPG 108 (↑) PPG 158 (↑) | Rapid Ab IgM (+) IgG (+) | RPG 427-204-342 RT-PCR NP (-) OP (-) (Result on Day 21) | FPG 140 (↑) PPG 273 (↑) | CBC Hb 10.5 (↓) Leu 15.52 (↑) Eos 0.2 (↓), Mon 3.5 (↓) Lym 4.4 (↓), Neut 91.5 (↑) CRP 334 (↑) FPG 150 (↑), PPG 135 Urinalysis Slightly opaque Protein 1+ (↑), Blood 2+ (↑) Leucocyte esterase 2+ (↑) Epithelial cells 4 (↑) Leucocyte 18 (↑) Erythrocyte 10 (↑) Blood culture Yeast cells (+) (Result on Day 24) | PT 11.5 (↑) D-dimer 7,660 (↑↑) Ur 71 (↑), Crea 1.7 (↑) eGFR 30.3 (↓) Kalium 5.8 (↑) Proc 2 (↑) Alb 2.07, Glob 3.94 BilTot 1.22 (↑) BilD 0.69 (↑) AST 44 (↑) GGT 163 (↑), AF 231 (↑) ABG pH 7.33 (↓) pCO2 33.0, PaO2 136 (↑) HCO3 17.3 (↓) BE -6.70 SaO2 99.20 Temp 38.6 FiO2 100 | CBC Hb 8.8 (↓) Leu 24.63 (↑) Eos 0.2 (↓), Mon 3.5 (↓) Lym 7.2 (↓) Neut 88.8 (↑) aPTT 45.7 (↑) Chloride 116 (↑) RPG 211-102 ABG pH 7.37 pCO2 27.0, PaO2 77 (↑) HCO3 15.9 (↓) BE -7.40 SaO2 95.40 Temp 37.0 FiO2 90 | aPTT 68.6 (↑) RPG 208-175-353-117 ABG (1st) pH 6.97 pCO2 99.4 (↑), PaO2 106 (↑) HCO3 23.1 BE -9.40 SaO2 93.00 Temp 38.3 FiO2 100 ABG (2nd) pH 6.97 pCO2 89.5 (↑), PaO2 150 (↑) HCO3 21.1 BE -10.40 SaO2 97.70 Temp 36.5 FiO2 100 | |||||
| Imaging | CXR Infiltrates in left perihilar and bilateral laterobasal areas | CXR Bilateral paracardiac infiltrate | CXR Decrease in perihilar and paracardiac infiltrates | CT Bilateral GGO suggestive of viral pneumonia | CXR Increased infiltrates in bilateral perihilar and paracardiac regions | CXR Increased pulmonary infiltrate in both lungs | ||||||||||||||||||||
[i] RR, respiratory rate (in times/minute); SaO2, saturation of oxygen in blood (in %); NRM, non-rebreathing mask; NIPPV, non-invasive positive pressure ventilation; CBC, complete blood count; Bas, basophil count (in %); Eos, eosinophil count (in %); Mon, monocyte count (in %); Lym, lymphocyte count (in %); Neut, neutrophil count (in %); CRP, C-reactive protein (in mg/L); Ur, blood urea (in mg/dL); Crea, blood creatinine (in mg/dL); eGFR, estimated glomerular filtration rate; Alb, albumin (in g/dL); Glob, globulin (in g/dL); BilTot, total bilirubin (in mg/dL); BilD, bilirubin; direct (in mg/dL); BilI, bilirubin; indirect (in mg/dL); AST, aspartate transaminase (in U/L); ALT, alanine transaminase (in U/L); GGT, gamma-glutamyl transferase (in U/L); LDH, lactate dehydrogenase (in U/L); Ferr, ferritin (in ng/mL); Proc, procalcitonin (in ng/mL); FPG, fasting plasma glucose (in mg/dL); PPG, post-prandial plasma glucose (in mg/dL); RPG, random plasma glucose (in mg/dL); BE, base excess (in mmol/L); FiO2, fraction of oxygen (in %); Temp, body temperature (in °C); PT, prothrombin time (in seconds); aPTT, activated partial thrombin time (in seconds); L/min, litres per minute; CXR, chest X-ray; CT, computed tomography; NC, Nasal Canule; GGO, Ground Glass opacities; PC, Pressure Control; PEEP, Positive End Expiratory Pressure; ABG, Arterial Blood Gas.
[ii] Note: Yellow highlight denotes the day the patient died.