Case 5: Acute respiratory distress syndrome
A 14-year-old female with history of glucose-6-phosphate dehydrogenase
(G6PD) deficiency was admitted with fever, cough, dyspnea, and sudden
loss of consciousness. The patient experienced fever and cough seven
days before admission. Vital signs included temperature = 38.2, systolic
blood pressure = 60/50 mmHg, heart rate = 145/min, and
O2 saturation = 60% without an oxygen supply. She was
immediately intubated, and vasopressors were initiated. Chest CT scan
revealed bilateral diffuse GGO and consolidations (Figure 1E). Moreover,
the patient was anemic (hemoglobin = 6 gram/dL). Echocardiography
demonstrated an LVEF of 15%, no pleural effusion, normal inferior vena
cava, pulmonary arterial pressure of 30 mmHg, and normal LV and RV size.
The patient received intravenous (IV) broad-spectrum antibiotics
(meropenem and doxycycline), high-dose corticosteroid (1 gr
methylprednisolone/day), and remdesivir for COVID-19. The patient died
due to acute respiratory distress syndrome (ARDS).