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.