Case 3
This is the case of a 68-year-old man with hypertension who presented with fever, diarrhea, and dry cough. He was diagnosed with COVID-19 on day 11. Although LPV/r was initiated after diagnosis, he manifested respiratory failure from day 12. HCQ has been added for his treatment on day 16, ABPC/SBT on day 18, ciclesonide on day 19, and AZM and low-dose steroid (hydrocortisone 250mg/day) on day 22. He needed IMV due to a progressive respiratory failure on day 23. P/F was 170, which was classified as moderate ARDS at that time. IVIG, sivelestat, and PPT were started after intubation. The respiratory status improved temporarily, but P/F worsened with evident SOP. SPT (methylprednisolone 1000mg for three days) was initiated from day 29. After this therapy, P/F, LDH, and CT findings were improved (Figure 1. ). PSL was not administered after the pulse therapy. He was successfully extubated on day 30, negative conversion of RT-PCR was confirmed on day 51, and finally he was transferred to a rehabilitation hospital due to disuse syndrome without oxygen demand on day 59.