First COVID-19 episode (E1)
Sixty-five-year old male with past medical history of hypertension
admitted in the emergency department on February 6, 2020 (Day 0 – E1).
Diagnosis of hypertensive cerebellar haemorrhage with intraventricular
and subarachnoid haemorrhage that required decompressive craniectomy
(Day 1). Patient was moved postoperatively to the neurosurgery ward (Day
4). Condition of the patient deteriorated on Day 50: diminished oxygen
saturation (93%), no consolidation on chest X-ray, with lymphopenia of
800, IL-6 of 4.6, CRP of 1.1, and D-dimer of 800 ng/ml. On the same Day
50, patient´s SARS-COV2 RT-PCR (Specimen-1) result was positive; he was
moved to a COVID-19 ward in a different building and given
lopinavir/ritonavir and hydroxychloroquine for 10 days. On Day 69, a
second SARS-CoV-2 RT-PCR assay was done with positive result (Ct 19;
Specimen-2). Patient was returned to the neurosurgery ward, which had
been turned into a COVID-19 area. On day 74 radiological worsening was
noted in the left lung, coinciding with an inflammatory process:
lymphocytopenia (0.7 10E3/μ), low platelet count (125 10E3/μL),
increased DD (989 ng/mL), CRP of 4.4 mg/dL, ferritin of 778 μg/L, and
IL6 of 13.6 pg/mL. Treatment with methylprednisolone was initiated and a
SARS-CoV-2 RT-PCR (Specimen-3) performed on the same day (Day 74) with
positive result (Ct 25). SARS-CoV-2 RT-PCR assay performed on Day 87 was
negative, as well as subsequent tests on Days 108, 117, 147, 195, and
206. Patient was discharged on Day 207 to a long-term facility due to
persistent generalised muscle weakness.