COVID-19 - rapidly progressive acute respiratory distress syndrome (ARDS)
Presentation
Admitted with acute respiratory failure, fever (38ºC) and dyspnea. She was tachypneic (30 bpm), with lymphopenia and low oxygen saturation (SpO2 85%, PAFI<250).
Patient Data
On admission
Ill-defined bilateral alveolar consolidation with peripheral distribution.
Day 1
Radiological worsening, with changes within the lower lobes. Endotracheal tube and central venous line were required.
Day 2
Radiological worsening. Bilateral alveolar consolidation with panlobar change.
Day 3
Bilateral alveolar consolidation with panlobar change, with typical radiological findings of ARDS.
Case Discussion
24 hours after the last chest x-ray the patient passed away. COVID-19 is a novel viral pandemic with increasing incidence and a wide spectrum of disease severity. Many countries are currently (c. March 2020) experiencing community spread to persons without known infectious contacts. In Spain, the guidelines to determine who to test for COVID-19 are changing. This implies the risk that some patients discharged from the hospital at that moment, may develop days later, an ARDS.
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