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Clinical Course of Five COVID-19 Patients and Treatment Updates

Received: 10 July 2020     Accepted: 28 July 2020     Published: 20 August 2020
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Abstract

Coronaviruses (CoVs) are enveloped, positive-sense RNA viruses. A novel coronavirus (nCoV) was discovered to be a cause of pneumonia outbreak in Wuhan, China in late 2019. The World Health Organization (WHO) named the disease as Coronavirus Disease 2019 (COVID-19) and declared it as a pandemic in March 2020. Since the detection of the first case of COVID-19 in the United States on January 20th, 2020 in Washington State, the pandemic is still expanding. As of July 8th, the United States (U.S.) has the maximum number (3.1 million) of confirmed COVID-19 patients. In this case series, we are presenting the clinical course of the first five confirmed COVID-19 cases admitted to a community hospital in the U.S. in the beginning of March 2020. We analyzed their clinical characteristics, pre-existing comorbidities, laboratory and radiological findings. The clinical management and outcomes are discussed alongside the literature review about current management options. In conclusion, primary management is supportive care to improve oxygenation by various methods. Safety and efficacy of treatment options including ramdesevir, IL-6 inhibitors and convalescent plasma have not yet been established and none of these is FDA approved so far. Increased age (>80 years), hypoxia at the time of presentation and pre-existing co-morbidities are likely related with poor outcomes.

Published in International Journal of Infectious Diseases and Therapy (Volume 5, Issue 3)
DOI 10.11648/j.ijidt.20200503.17
Page(s) 74-80
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Pneumonia, Coronavirus, Pandemic

References
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[2] "New Cases of COVID-19 In World Countries." Johns Hopkins Coronavirus Resource Center. Accessed July 10, 2020. https://coronavirus.jhu.edu/data/new-cases.
[3] Verity, R., Okell, L. C., Dorigatti, I., Winskill, P., Whittaker, C., Imai, N., Cuomo-Dannenburg, G., Thompson, H., Walker, P. G., Fu, H., Dighe, A., Griffin, J. T., Baguelin, M., Bhatia, S., Boonyasiri, A., Cori, A., Cucunubá, Z., FitzJohn, R., Gaythorpe, K., Ferguson, N. M. (2020). Estimates of the severity of coronavirus disease 2019: A model-based analysis. The Lancet Infectious Diseases. https://doi.org/10.1016/s1473-3099(20)30243-7.
[4] Omer, Saad B., Preeti Malani, and Carlos Del Rio. "The COVID-19 Pandemic in the US." JAMA, 2020. doi: 10.1001/jama.2020.5788.
[5] Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., Wang, B., Xiang, H., Cheng, Z., Xiong, Y., Zhao, Y., Li, Y., Wang, X., & Peng, Z. (2020). Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA, 323 (11), 1061. https://doi.org/10.1001/jama.2020.1585.
[6] World Health Organization. Coronavirus disease (COVID-19) technical guidance: Surveillance and case definitions. https://www.who.int/emergencies/diseases/novelcoronavirus-2019/technical-guidance/surveillance-and-case-definitions.
[7] Chung, M., Bernheim, A., Mei, X., Zhang, N., Huang, M., Zeng, X., Cui, J., Xu, W., Yang, Y., Fayad, Z. A., Jacobi, A., Li, K., Li, S., & Shan, H. (2020). CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology, 295 (1), 202-207. https://doi.org/10.1148/radiol.2020200230.
[8] Salehi, S., Abedi, A., Balakrishnan, S., & Gholamrezanezhad, A. (2020). Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. American Journal of Roentgenology, 1-7. https://doi.org/10.2214/ajr.20.23034.
[9] Xie, X., Zhong, Z., Zhao, W., Zheng, C., Wang, F., & Liu, J. (2020). Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing. Radiology, 200343. https://doi.org/10.1148/radiol.2020200343.
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[11] Wu, Zunyou, and Jennifer M. McGoogan. "Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China." JAMA 323, no. 13 (2020), 1239. doi: 10.1001/jama.2020.2648.
[12] "Mortality Analyses." Johns Hopkins Coronavirus Resource Center. Accessed July 10, 2020. https://coronavirus.jhu.edu/data/mortality.
[13] Onder, G., Rezza, G., & Brusaferro, S. (2020). Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. https://doi.org/10.1001/jama.2020.4683.
[14] Wu, C., Chen, X., Cai, Y., Xia, J., Zhou, X., Xu, S., Huang, H., Zhang, L., Zhou, X., Du, C., Zhang, Y., Song, J., Wang, S., Chao, Y., Yang, Z., Xu, J., Zhou, X., Chen, D., Xiong, W. Song, Y. (2020). Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2020.0994.
[15] Coronavirus disease 2019 (COVID-19). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html.
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Cite This Article
  • APA Style

    Mohsin Sheraz Mughal, Ikwinder Preet Kaur, Rameez Rehman, Hasan Mahmood Mirza, Harjot Singh Jagdey, et al. (2020). Clinical Course of Five COVID-19 Patients and Treatment Updates. International Journal of Infectious Diseases and Therapy, 5(3), 74-80. https://doi.org/10.11648/j.ijidt.20200503.17

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    ACS Style

    Mohsin Sheraz Mughal; Ikwinder Preet Kaur; Rameez Rehman; Hasan Mahmood Mirza; Harjot Singh Jagdey, et al. Clinical Course of Five COVID-19 Patients and Treatment Updates. Int. J. Infect. Dis. Ther. 2020, 5(3), 74-80. doi: 10.11648/j.ijidt.20200503.17

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    AMA Style

    Mohsin Sheraz Mughal, Ikwinder Preet Kaur, Rameez Rehman, Hasan Mahmood Mirza, Harjot Singh Jagdey, et al. Clinical Course of Five COVID-19 Patients and Treatment Updates. Int J Infect Dis Ther. 2020;5(3):74-80. doi: 10.11648/j.ijidt.20200503.17

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  • @article{10.11648/j.ijidt.20200503.17,
      author = {Mohsin Sheraz Mughal and Ikwinder Preet Kaur and Rameez Rehman and Hasan Mahmood Mirza and Harjot Singh Jagdey and Chandler Patton and Wael Ghali},
      title = {Clinical Course of Five COVID-19 Patients and Treatment Updates},
      journal = {International Journal of Infectious Diseases and Therapy},
      volume = {5},
      number = {3},
      pages = {74-80},
      doi = {10.11648/j.ijidt.20200503.17},
      url = {https://doi.org/10.11648/j.ijidt.20200503.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20200503.17},
      abstract = {Coronaviruses (CoVs) are enveloped, positive-sense RNA viruses. A novel coronavirus (nCoV) was discovered to be a cause of pneumonia outbreak in Wuhan, China in late 2019. The World Health Organization (WHO) named the disease as Coronavirus Disease 2019 (COVID-19) and declared it as a pandemic in March 2020. Since the detection of the first case of COVID-19 in the United States on January 20th, 2020 in Washington State, the pandemic is still expanding. As of July 8th, the United States (U.S.) has the maximum number (3.1 million) of confirmed COVID-19 patients. In this case series, we are presenting the clinical course of the first five confirmed COVID-19 cases admitted to a community hospital in the U.S. in the beginning of March 2020. We analyzed their clinical characteristics, pre-existing comorbidities, laboratory and radiological findings. The clinical management and outcomes are discussed alongside the literature review about current management options. In conclusion, primary management is supportive care to improve oxygenation by various methods. Safety and efficacy of treatment options including ramdesevir, IL-6 inhibitors and convalescent plasma have not yet been established and none of these is FDA approved so far. Increased age (>80 years), hypoxia at the time of presentation and pre-existing co-morbidities are likely related with poor outcomes.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Clinical Course of Five COVID-19 Patients and Treatment Updates
    AU  - Mohsin Sheraz Mughal
    AU  - Ikwinder Preet Kaur
    AU  - Rameez Rehman
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    JO  - International Journal of Infectious Diseases and Therapy
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    AB  - Coronaviruses (CoVs) are enveloped, positive-sense RNA viruses. A novel coronavirus (nCoV) was discovered to be a cause of pneumonia outbreak in Wuhan, China in late 2019. The World Health Organization (WHO) named the disease as Coronavirus Disease 2019 (COVID-19) and declared it as a pandemic in March 2020. Since the detection of the first case of COVID-19 in the United States on January 20th, 2020 in Washington State, the pandemic is still expanding. As of July 8th, the United States (U.S.) has the maximum number (3.1 million) of confirmed COVID-19 patients. In this case series, we are presenting the clinical course of the first five confirmed COVID-19 cases admitted to a community hospital in the U.S. in the beginning of March 2020. We analyzed their clinical characteristics, pre-existing comorbidities, laboratory and radiological findings. The clinical management and outcomes are discussed alongside the literature review about current management options. In conclusion, primary management is supportive care to improve oxygenation by various methods. Safety and efficacy of treatment options including ramdesevir, IL-6 inhibitors and convalescent plasma have not yet been established and none of these is FDA approved so far. Increased age (>80 years), hypoxia at the time of presentation and pre-existing co-morbidities are likely related with poor outcomes.
    VL  - 5
    IS  - 3
    ER  - 

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Author Information
  • Monmouth Medical Center, Long Branch, New Jersey, United States

  • Monmouth Medical Center, Long Branch, New Jersey, United States

  • Monmouth Medical Center, Long Branch, New Jersey, United States

  • Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, United States

  • BronxCare Health System, Bronx, United States

  • Monmouth Medical Center, Long Branch, New Jersey, United States

  • Monmouth Medical Center, Long Branch, New Jersey, United States

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