4 Conclusion and results:
Based on the patient’s medical history, symptoms, physical examination,
and lab results, we diagnosed the patient with COVID-19 related
Pneumonia along with Dengue Fever. Initially, the patient received
hydration with intravenous Ringer’s lactate solution at a rate of 80
ml/h (total of 1920 ml) within the first 24 hours of admission before
the lab reports were available. Treatment included starting Ceftriaxone
2 g daily and Ciprofloxacin 400 mg twice daily to address potential
bacterial infections in COVID-19 cases. Additionally, Low Molecular
Weight Heparin (Enoxaparin 60 mg subcutaneous injection twice daily) was
initiated to prevent clotting issues associated with COVID-19. To manage
stress ulcers, Injection Omeprazole 40 mg IV once daily was
administered, along with Domperidone 10 mg three times daily before
meals to reduce gastrointestinal disturbances due to the patient’s
history of vomiting. To leverage their antiviral properties, Zinc 20 mg,
Vitamin C 250 mg, Vitamin D 1000 IU, and Famotidine 20 mg were included
in the treatment plan.
Following treatment, the patient experienced a bout of blood-vomiting
within the initial 24 hours of admission and later developed a fever
(one-time occurrence, without chills or shivering, temperature reaching
39 °C) during that period. The fever was managed with sponging and oral
Paracetamol 500 mg (2 tablets at once). The fever resolved by the second
day of hospitalization. The patient maintained good oxygen saturation
levels and had uneventful breathing patterns throughout their stay.
Intravenous fluid management was adjusted based on hematocrit levels for
dengue management. Vital signs such as blood pressure, pulse rate, fluid
intake-output, respiratory rate, and temperature were regularly
monitored every 6 hours. The patient did not require oxygen therapy or
steroids to prevent a cytokine storm. Upon discharge, the patient was
afebrile, well-hydrated, and free from respiratory distress. They were
advised to continue treatment at home isolation.