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Successful treatment with Remdesivir and corticosteroids in a patient with COVID-19-associated pneumonia: A case report

Medwave. 2020;20(07) DOI 10.5867/medwave.2020.07.7998

 

Journal Homepage

Journal Title: Medwave

ISSN: 0717-6384 (Online)

Publisher: Medwave Estudios Limitada

LCC Subject Category: Medicine: Medicine (General)

Country of publisher: Chile

Language of fulltext: English, Spanish

Full-text formats available: PDF, HTML

 

AUTHORS


José A Gonzales-Zamora (Department of Medicine, Division of Infectious Diseases. University of Miami, Miller School of Medicine. Miami, Florida 33136. USA)

Tanya Quiroz (Jackson Health System. Jackson Memorial Hospital. Miami, Florida 33136. USA)

Ana D. Vega (Department of Pharmacy services. Jackson Memorial Hospital. Miami, Florida 33136. USA)

EDITORIAL INFORMATION

Peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 12 weeks

 

Abstract | Full Text

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread throughout the world causing significant mortality in high risk patients with severe manifestations. To date, Remdesivir has been the only antiviral authorized by FDA as therapy for emergency use. One of the potential complications of this infection is cytokine storm, which optimal treatment remains unknown. We present the case of a 48-year-old man with no past medical history who presented to the hospital with dyspnea, cough, subjective fever, and diarrhea for 10 days. Nasopharyngeal PCR was positive for SARS-CoV-2. His respiratory status rapidly worsened to the point of requiring supplemental oxygen by high flow nasal cannula with FiO2 of 80%. Chest computed tomography showed confluent ground glass opacities in upper lobes accompanied by patchy airspace opacities in lower lobes bilaterally. He was started on hydroxychloroquine, which was switched to Remdesivir when it became available. Then, methylprednisolone was initiated for suspected cytokine storm. The patient’s oxygenation improved significantly over the following days and he was discharged home with no oxygen supplementation and saturating 96% on room air. Our case illustrates the role of Remdesivir for the treatment of severe COVID-19 pneumonia. We also observed a possible clinical benefit of corticosteroids in the context of suspected cytokine storm. Further studies are needed to evaluate this therapeutic strategy.