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CEN Case Rep ; 9(4): 404-408, 2020 11.
Artigo em Inglês | MEDLINE | ID: covidwho-603821

RESUMO

On 31 December 2019, cases of pneumonia whose cause was later identified as SARS-CoV-2 were detected in Wuhan City, Hubei Province of China, and now COVID-19 has spread worldwide. On March 1, 2020, a 69-year-old Japanese man who had been on hemodialysis for 3 years was diagnosed as having COVID-19 pneumonia and hospitalized at our Medical Center. Pulmonary CT revealed bilateral multiple consolidation with bilateral pleural effusion. Aggressive weight reduction was needed to improve the patient's respiratory condition. Hemodialysis therapy was performed in isolation with hydroxychloroquine administration, but the formation of a dialysis membrane clot forced the withdrawal of dialysis therapy. Changing the dialysis membrane material and anticoagulant enabled the resumption of dialysis therapy, allowing the body weight to correct downward. On the 5th hospitalization day, the patient's fever dropped and he showed improved oxygenation and chest X-ray. He was eventually discharged. The hydroxychloroquine and appropriate fluid management may have contributed to the patient's recovery. Clinicians should pay close attention to avoid dialysis-related problems when treating a patient with COVID-19.


Assuntos
Infecções por Coronavirus , Hidroxicloroquina/administração & dosagem , Falência Renal Crônica , Pandemias , Derrame Pleural , Pneumonia Viral , Diálise Renal , Idoso , Anti-Infecciosos/administração & dosagem , Anticoagulantes/uso terapêutico , COVID-19 , Terapia Combinada , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Humanos , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/terapia , Pulmão/diagnóstico por imagem , Masculino , Membranas Artificiais , Derrame Pleural/diagnóstico , Derrame Pleural/etiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Pneumonia Viral/fisiopatologia , Diálise Renal/instrumentação , Diálise Renal/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
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