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).