Case history:
A 42-year-old woman with Down’s Syndrome, a background of hypothyroidism
on L-thyroxine, and diabetes mellitus developed a fever on 10th January
2022, and the next day, she had mild cough associated weakness. She had
no history of vaccination against COVID-19. On 12th January 2022, she
underwent a COVID-19 test and became positive; the same day, she started
tab Azythromycin 500mg once daily, tab Motelukust 10mg once at night and
tab paracetamol 500 mg 8 hourly as physician advised. Her vital was
within the standard limit the following week except for temperature. She
was admitted to the COVID-19 department, Feni hospital, on 21st January
2022, with respiratory distress progressively worsening over the last
few days and was accompanied by fever, myalgia, and cough. At the time
of the patient’s admission, the clinical assessment was done, which
revealed neurological stability with a Glasgow score of 15/15, body
temperature of 38.2 degrees Celsius with a heart rate of 98 beats per
minute, blood pressure (BP) of 130/80 mmHg, peripheral oxygen saturation
(SpO2) at ambient air (AA) of 95 per cent with Arterial blood gas test
(Table: 01) and underwent routine and relevant investigation (Table:
01). Then she was referred to Chittagong hospital due to better
facilities and got admitted on 25th January 2022. Again, they do, the
nasopharyngeal swab PCR test for SARS-CoV-2 was negative on that day,
but a CT scan (computerized tomography) revealed bilateral ground-glass
pneumonia with an estimated 30 per cent parenchymal involvement and no
sign of pulmonary embolism (Figure: 01). She again did the blood test
and urine test (Table:01) and started the treatment as per protocol
(Table:02), including continuous positive airway pressure (CPAP). She
was transported to the cabin on 1st February 2022, with oxygen delivery
at a rate of 2-3 L per minute through a nasal route due to her improved
respiratory status. She was later discharged on 6th February 2022 with
medication and respiratory exercise with stable conditions.