Table 3.
Clinical summaries of IMD patients who required intensive care hospitalization during COVID-19 infection.
| Patient no. | Age (year) | Gender | IEM diagnosis | COVID-19 related symptoms | IEM related symptoms | Management | Comment |
|---|---|---|---|---|---|---|---|
| 1 | 23 | M | ASA | Fever, shortness of breath & diarrhea | Abdominal pain, nausea, fatigability, hyperammonemia, metabolic acidosis, acute necrotic pancreatitis, acute elevation of liver transaminases | IV hydration, IV ammonia scavengers, IV sodium bicarbonate, IV meropenem, vancomycin, Oxygen support via nasal cannula | |
| 2 | 2 | F | VLCADD | Fever, diarrhea &lethargy | Rhabdomyolysis and acute elevation of liver transaminases | IV hydration Azithromycin, hydroxychloroquine |
|
| 3 | 16 | M | PA | Fever, tiredness, dry cough, & shortness of breath | Metabolic acidosis and acute pancreatitis | IV hydration, sodium bicarbonate | |
| 4 | 17 | M | PA | Fever, tiredness, dry cough, shortness of breath & respiratory failure | Hypperammonemia, metabolic acidosis, and pancytopenia | IV ammonia scavengers, IV sodium bicarbonate, azithromycin, hydroxychloroquine | |
| 5 | 16 | M | PA | Fever, shortness of breath requiring | Hyperammonemia and metabolic acidosis | IV ammonia scavengers, high flow oxygen support via nasal cannula, azithromycin, hydroxychloroquine, ceftriaxone | |
| 6 | 22 | M | ASA | Decrease activity & tiredness | Hyperammoneima, metabolic acidosis, hyponatremia and hypokalemia | IV ammonia scavengers, IV electrolytes | |
| 7 | 28 | M | MMA (k/c of chronic renal failure) | Shortness of breath and pneumonia | Vomiting, decreased activity, refractory metabolic acidosis and hyperkalemia | Hemodialysis, azithromycin, hydroxychloroquine, tocliozumab | |
| 8 | 16 | F | MMA | Fever, shortness of breath, pneumonia & respiratory failure | Hospital course complicated by severe metabolic acidosis. Died from cardiac arrest after a month of stay at local hospital | Invasive ventilator support, IV sodium bicarbonate |
Died |
| 9 | 21 | M | MMA | Decreased activity, uncontrolled seizure episodes and sepsis | Patient died at local hospital | NA | Died |
| 10 | 30 | M | MPS IV (k/c of restrictive lung disease) | Fever and severe shortness of breath | Patient died within 3 h from presentation to local hospital's emergency | NA | Died |
M male; F female; k/c known case; NA data not available; ASA arginioscuccinic aciduria; VLCADD Very long-chain Acyl-CoA dehydrogenase deficiency; PA Propionic Acidemia; MMA Methylmalonic Acidemia; MPS-IV Mucopolysarcoidosis type IV.