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Abstract: This is a case of a middle-aged female with a history of travel to a novel coronavirus pneumonia epidemic area. She came to the fever clinic with a low fever with respiratory symptoms, had routine blood tests for leukopenia, normal calcitoninogen, and lung CT suggestive of viral pneumonia, and was given isolation for observation. She was transferred to the designated isolation site for further isolation treatment.
Basic information】Female, 49 years old
Disease Type】Coronavirus infection
Hospital】Liaoning Provincial People’s Hospital
Date of consultation】October 2019
【Treatment plan】Oral medication (Abidor Hydrochloride Tablets + Oseltamivir Phosphate Capsules + Lianhua Qingfei Capsules + Moxifloxacin Hydrochloride Tablets)
[Treatment cycle] Hospitalization for 7 days, transferred to the designated hospital
Treatment effect] The patient’s condition was initially improved
I. Initial consultation
A middle-aged female with a history of travel to an epidemic area with novel coronavirus pneumonia 10 days ago, the patient developed a cough with no obvious cause 10 days ago and did not pay attention to it. 4 days ago, the cough started to worsen, accompanied by sore throat, headache, joint pain, self-conscious fever, with a maximum temperature of 37.1℃, no chest tightness or shortness of breath, and no respiratory distress. Laboratory tests returned: blood routine abnormalities, leukopenia, lung CT returned: viral pneumonia. The patient’s epidemiological history, fever, respiratory symptoms and auxiliary examinations were combined, and the fever clinic isolated the patient as a suspected case of novel coronavirus pneumonia after expert consultation. 2 days ago, the Municipal Center for Disease Control and Prevention reported that the patient tested positive for novel coronavirus nucleic acid and confirmed the diagnosis of novel coronavirus pneumonia.
II. Treatment history
After admission to the hospital, the patient was isolated in a single room for respiratory infectious diseases, with routine secondary care, bed rest, and advised to drink more water. The patient was given fluids. The relevant tests were completed and the laboratory results were returned: routine blood leukocyte count: 2.9×10^9/L, monocyte percentage: 16.0%, eosinophil percentage: 0.3%, absolute neutrophil value: 1.2×10^9/L; C-reactive protein, calcitoninogen, D-dimer were not abnormal; liver and kidney function, blood ions were normal; lung CT: subpleural patchy fuzzy shadow was seen in the dorsal segment of the right lower lobe. High-density shadow with blurred margins, preliminary diagnosis of pulmonary inflammation. Combined with the epidemiological history, symptoms, signs, blood routine, pulmonary CT and other examinations and the positive nucleic acid result of CDC2 novel coronavirus pneumonia, the diagnosis of novel coronavirus pneumonia (common type) was clear. Abidor hydrochloride tablets, oseltamivir phosphate capsules and Lianhua Qingfei capsules were given orally to clear the heat and detoxify the toxin and improve the symptoms, together with moxifloxacin hydrochloride tablets given orally to anti-infection and prevent secondary bacterial infection.
III. Treatment effect
After systemic treatment, a repeat lung CT showed that the patient’s lung inflammatory lesions had slightly progressed compared with the previous ones. After about 7 days of hospitalization, the patient’s condition stabilized, and symptoms such as sore throat, headache and joint pain improved significantly without fever symptoms, and the patient was transferred to a designated hospital in accordance with the management of New Crown pneumonia, and the patient was followed up regularly by telephone.
IV. Notes
We are glad that the patient’s symptoms are under control and his condition has improved, but we still need to advise the patient to take the following precautions after discharge.
1. Patients still need to strengthen nutrition to ensure the intake of calories, proteins, carbohydrates, vitamins and other substances to maintain the immunity and physical strength of the body to avoid excessive consumption caused by the disease, which is not conducive to the recovery of the disease.
2, patients need to rest in bed, relax, do not be too anxious because of the infection of new coronavirus pneumonia, causing great psychological pressure, affecting the effectiveness of treatment, and can even lead to aggravation of the disease.
3, according to the characteristics of the onset of novel coronavirus pneumonia, if symptoms such as progressive dyspnea, hypoxemia, chest tightness and shortness of breath appear after discharge, seek medical attention promptly.
4.After the physical recovery of discharged patients, due to intrapulmonary infection can lead to pleural adhesions, pulmonary atelectasis, etc. Pay attention to the exercise of respiratory function, you can choose tai chi, yoga, etc., to improve lung function through even breathing.
V. Personal insight
Novel coronavirus is a new coronavirus infection that is extremely contagious, so Category B infectious diseases are managed according to Category A infectious diseases, and extra attention needs to be paid to personal protection for contact isolation of confirmed and suspected patients. Novel coronavirus pneumonia is a viral infection, but the clinical symptoms lack specificity and are difficult to distinguish from other upper respiratory tract infections, so epidemiological information is very important, and detailed epidemiological history of the patients seen is required. Isolation and treatment according to the guidelines for the prevention and treatment of novel coronavirus pneumonia can be combined with Chinese and Western medicine, and usually, as in this patient, the disease can be significantly relieved and cured after aggressive treatment.