Table 1.
Patient 1 |
Patient 2 |
Patient 3 |
Patient 4 |
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---|---|---|---|---|---|---|---|---|---|---|---|---|
Admission | Exacerbation | Progression | Admission | Exacerbation | Recovery | Admission | Exacerbation | Recovery | Admission | Exacerbation | Recovery | |
Date | 17-Jan | 26-Jan | 16-Feb | 21-Jan | 26-Jan | 6-Feb | 25-Jan | 27-Jan | 13-Feb | 30-Jan | 3-Feb | 15-Feb |
Vital sign | ||||||||||||
Heart rate | 67 | 42 | 88 | 95 | 68 | 72 | 82 | 66 | 84 | 110 | 58 | 72 |
Respiratory rate | 30 | 12 (muscle relaxation) | 20 (sedation) | 16 | 29 | 18 | 17 | 35 | 22 | 18 | 32 | 19 |
Blood pressure, mmHg | 105/65 | 92/52 | 110/60 | 123/85 | 84/57 | 125/65 | 126/76 | 90/60 | 100/60 | 126/90 | 105/60 | 106/62 |
Temperature, oC | 37.5 | 36.4 | 36.5 | 38 | 36.5 | 36.7 | 37.8 | 38.6 | 36.5 | 37.9 | 38.5 | 36.5 |
SpO2, % | 92 | 94 | 99 | 95 | 92 | 97 | 96 | 88 | 96 | 97 | 86 | 98 |
Oxygen support | HFNC (50 L/min, FiO2 40%) | Mechanical ventilation + VV-ECMO | Mechanical ventilation + VV-ECMO | Room air | HFNC (45 L/min, FiO2 45%) | Nasal cannula | Room air | Mechanical ventilation | HFNC (25 L/min, FiO2 45%) | Room air | HFNC (40 L/min, FiO2 50%) | Nasal cannula |
PaO2/FiO2 | 220.5 | 64.2 | 187.5 | 467.6 | 184.4 | 329.4 | 455.7 | 61.27 | 302 | 452.9 | 208 | 371.4 |
PaCO2, mmHg | 29.4 | 44.3 | 45 | 42.3 | 40.9 | 41.4 | 36.4 | 27.8 | 41.9 | 36.9 | 35.2 | 35.9 |
pH | 7.402 | 7.412 | 7.316 | 7.372 | 7.379 | 7.421 | 7.42 | 7.494 | 7.442 | 7.406 | 7.378 | 7.415 |
Lactic acid, mmol/L | 1.9 | 1.5 | 2.2 | 1.8 | 3.2 | 1.1 | 2 | 2.4 | 1.4 | 2.4 | 1.7 | 2 |
White blood cell count, ×109/L | 9.9 | 9.24 | 19.52 | 6.2 | 8.25 | 4.59 | 4.7 | 6.34 | 6.26 | 4.77 | 4.9 | 4.05 |
Neutrophil cell count, ×109/L | 9.49 | 7.94 | 14.42 | 4.31 | 7.38 | 2.16 | 2.94 | 4.1 | 3.87 | 3.47 | 3 | 2.42 |
Lymphocyte count, ×109/L | 0.3 | 0.59 | 1.98 | 1.48 | 0.45 | 1.77 | 1.08 | 1.73 | 1.33 | 0.88 | 1.7 | 1.04 |
Procalcitonin, ng/mL | <0.1 | 0.73 | 1.12 | <0.1 | <0.1 | <0.1 | <0.1 | 0.17 | 0.1 | 0.19 | <0.1 | 0.15 |
C-reactive protein, mg/L | 154.3 | 206.2 | 102.96 | 58.17 | 11.64 | 2.18 | 17.07 | 59.28 | 5.68 | 46.15 | 105.34 | 9.17 |
Total bilirubin, μmol/L | 6.3 | 47.56 | 21.77 | 9.4 | 16.12 | 11.1 | 8.64 | 33.81 | 7.46 | 11.2 | 25.08 | 7.46 |
Albumin, g/L | 32.9 | 38.8 | 51.3 | 41.1 | 35.4 | 42.8 | 39.5 | 35.2 | 41.9 | 40.8 | 38.5 | 43.5 |
Lactate dehydrogenase, U/L | 351 | 286 | 745 | 271 | 260 | 166 | 177 | 283 | 229 | 203 | 399 | 196 |
Creatine kinase, U/L | 32 | 28 | 71 | 47 | 41 | 24 | 123 | 167 | 24 | 108 | 463 | 50 |
Troponin I, ng/mL | <0.01 | 0.024 | <0.01 | <0.01 | <0.01 | <0.01 | <0.01 | <0.01 | <0.01 | <0.01 | <0.01 | <0.01 |
B-type natriuretic Peptide, pg/mL | 1210 | 4657 | 3100 | 263 | 1660 | 122 | 34 | 2820 | 66 | 171 | 2780 | 411 |
Creatinine, μmol/L | 76 | 94.4 | 135.4(CRRT) | 52 | 48.4 | 61.4 | 71.5 | 70.8 | 53.5 | 80.8 | 74 | 64.8 |
Prothrombin time, s | 14.3 | 15.7 | 14.1 | 16.5 | 11.4 | 11.1 | 12.6 | 13.3 | 13.1 | 13.1 | 12.5 | 11.7 |
Activated partial thromboplastin time, s | 30.4 | 29.7 | 40.7 | 29.6 | 25.5 | 26.9 | 34.9 | 38.1 | 29.6 | 32.7 | 32.2 | 28.3 |
D-dimer, mmol/L | 460 | 17,308 | 1575 | 93 | 253 | 130 | 415 | 392 | 2954 | 89 | 111 | 472 |
Potassium, mmol/L | 3.7 | 4.02 | 4.95 | 3.7 | 3.9 | 4.16 | 3.44 | 3.25 | 3.74 | 3.47 | 3.38 | 4.0 |
Sodium, mmol/L | 136 | 141 | 138 | 138 | 142 | 143 | 135 | 133 | 135 | 137 | 141 | 137 |
SARS-CoV-2 RT-PCR | ||||||||||||
Nasal or throat swab | + | + | + | + | + | – | + | + | – | + | + | – |
Blood | – | + | – | – | + | – | – | + | – | – | + | – |
Stool | – | + | + | – | + | – | – | + | + | – | + | + |
Urine | / | + | + | – | – | – | / | – | – | – | – | – |
Pleural effusion | / | + | + | / | / | / | / | / | / | / | / | / |
Corticosteroid therapy | 80 mg Methylprednisolone on dayb 6 | 500 mg Methylprednisolone on day 8 | 500 mg Methylprednisolone on day 6 | 250 mg Methylprednisolone on day 7 | ||||||||
Duration of positive SARS-CoV-2 tested in blood | 10 days | 2 days | 3 days | 3 days | ||||||||
Duration of Excerbationa | Persistant | 11 days | 15 days | 12 days | ||||||||
Prognosis | Progress | Recovery | Recovery | Recovery |
Duration of exacerbation: time to recover from hemodynamic instability and PaO2/FiO2 less than 300.
Days were counted from admission.