PMC7371855_01
Time line. Symptoms, diagnostic tests and treatment. HP, hospitalization; ICU, intensive care unit; D, discharged day; A, transient anosmia; LCT, lung computed tomography; CMRI, cardiac magnetic resonance imaging; CTCA, computed tomography coronary angiography; PCR Nas, SAR-CoV-2 PCR on nasopharyngeal smear; PCR BAL, SAR-CoV-2 PCR on bronchoalveolar lavage; S, SAR-CoV-2 serology; HYQ, Hydroxychloroquine 400 mg bid during 2 days and then 200 mg; AZI, Azithromycine 500 mg on day 1 than 250 mg/day; COL, Colchicine 0.5 mg bid; mPDN, methyprednisolone 60 mg IV bid initially, 48 mg oral dose at discharge; 24 mg at May 14; CEF, ceftriaxone 2 g/d; TOCI, tocilizumab IV 480 mg; IVIG, Privigen 60 g.
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F1
Symptoms time line are depicted on Figure 1.
Evolution of eosinophils, lymphocytes, serum CRP and troponin T. mPDN, methyprednisolone 60 mg IV bid initially, 48 mg oral dose at discharge; 24 mg at May 14; COL, Colchicine 0.5 mg bid; TOCI, tocilizumab IV 480 mg; IVIG, Privigen 60 g.
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F2
The evolution of principal blood parameters is depicted in Figure 2 and hemodynamic and organ function variables in Figure 3. PaO2/FiO2, CRP, and Troponin T rapidly improved (Figures 2, 3).
Evolution of hemodynamic and organ function variables. Oxygenation was assessed by PaO2/FiO2 ratio and renal function by serum creatinine levels BPM beats per minute. TOCI, tocilizumab; COL, colchicine; DOBU, dobutamine; mPDN, methylprednisolone; IVIG, Privigen 60 g; GIAP, Giapreza.
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F3
The evolution of principal blood parameters is depicted in Figure 2 and hemodynamic and organ function variables in Figure 3. PaO2/FiO2, CRP, and Troponin T rapidly improved (Figures 2, 3).
Computed Tomography Coronary Angiography. (A) The first exam was performed on April 27, 13 days after the onset of the disease, 6 days after tocilizumab administration and 3 days after intravenous immunoglobulins. A 5 mm fusiform ectasia is present at the proximal part of the anterior interventricular coronary artery (arrow). The external diameter of the artery is 3 mm above and below the ectasia; dilation area 19,3 mm2. (B) Second exam, performed on May 14, demonstrating a marked decrease in aneurism size. Four millimeter fusiform ectasia; dilation area 10,6 mm2.
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F4
A computed tomography coronary angiography (CTCA) demonstrated a coronary artery aneurism and high dose steroids were initiated, resulting in significative improvement 17 days later (Figure 4).