14 November 2020: Clinical Research
A Retrospective Study of Coinfection of SARS-CoV-2 and in 11 Hospitalized Patients with Severe COVID-19 Pneumonia at a Single Center
Guillermo Rodriguez-Nava 1ABCDEF* , Maria Adriana Yanez-Bello 1ABDEF , Daniela Patricia Trelles-Garcia 1ABDEF , Chul Won Chung 1ABD , Goar Egoryan 1EF , Harvey J. Friedman 23ADOI: 10.12659/MSM.928754
Med Sci Monit 2020; 26:e928754
Table 1 Characteristics of patients with SARS-CoV-2 and Streptococcus pneumoniae coinfection.
| Patient No. | Age/Sex/Ethicity/Dwelling | Commorbidities | Clinical presentation | Vital sings on admission | Relevant Lab on admission | ||
|---|---|---|---|---|---|---|---|
| Patient 1 | 92FemaleBlack or African AmericanHome | Hypertension, hyperlipidemia, T2D | Fever, shortness of breath, weakness, myalgia, fatigue, altered mental status | TEMP: 38.1°CSBP: 145 mmHgRR: 22 rpmHR: 116 bmpO2: 94% | WBC: 11.8 k/mmPCT: 1.96 ng/mlLAC: 1.0 mmol/LDD: 6945 ng/mL FEUFerritin: 451 ng/mLLDH: 514 IU/LCRP: 15.3 mg/dL | ||
| Patient 2 | 82FemaleCaucasianLTCF | Hypertension, T2D, atrial, fibrilation, asthma, dementia | Cardiac arrest, hypoxia | TEMP: 36.2°CSBP: 85 mmHgRR: 14 rpmHR: 51 bmpO2: 96% | WBC: 34.7 k/mmPCT: 4.41 ng/mlLAC: 9.5 mmol/LDD: 5755 ng/mL FEUFerritin: 1301 ng/mLLDH: 2335 IU/LCRP: 0.4 mg/dL | ||
| Patient 3 | 75MaleCaucasianLTCF | Hyperlipidemia, OSA, seizures, CVA | Altered mental status, shortness of breath | TEMP: 39°CSBP: 140 mmHgRR: 66 rpmHR: 116 bmpO2: 90% | WBC: 9.9 k/mmPCT: 3.37 ng/mlLAC: NADD: 4062 ng/mL FEUFerritin: 821 ng/mLLDH: 402 IU/LCRP: 18.4 mg/dL | ||
| Patient 4 | 77FemaleCaucasianLTCF | Hypertension, hyperlipidemia, COPD, DVT, SVT | Shortness of breath, lethargy | TEMP: 39.5°CSBP: 69 mmHgRR: 30 rpmHR: 100 bmpO2: 75% | WBC: 6.4 k/mmPCT: 23.98 ng/mlLAC: 2.4 mmol/LDD: 3694 ng/mL FEUFerritin: 722 ng/mLLDH: 465 IU/LCRP: 41.90 mg/dL | ||
| Patient 5 | 81MaleCaucasianLTCF | COPD-asthma overlap, hyperlipidemia, T2D | Shortness of breath, cough, fever, chills | TEMP: 38.8°CSBP: 165 mmHgRR: 31 rpmHR: 119 bmpO2: 93% | WBC: 7.6 k/mmPCT: 1.21 ng/mlLAC: 2.6 mmol/LDD: 4522 ng/mL FEUFerritin: 175 ng/mLLDH: 180 IU/LCRP: 18.10 mg/dL | ||
| Patient 6 | 74FemaleHispanicLTCF | Hypertension, dementia, pre-diabetes | Shortness of breath, lethargy | TEMP: 39.5°CSBP: 80 mmHgRR: 28 rpmHR: 106 bmpO2: 91% | WBC: 14.5 k/mmPCT: 11.47 ng/mlLAC: 7.4 mmol/LDD: 19443 ng/mL FEUFerritin: 2126 ng/mLLDH: 405 IU/LCRP: 21.3 mg/dL | ||
| Patient 7 | 90FemaleHispanicLTCF | Hypertension, T2D | Fatigue | TEMP: 36.9°CSBP: 80 mmHgRR: 18 rpmHR: 93 bmpO2: 97% | WBC: 6.6 k/mmPCT: 0.57 ng/mlLAC: NADD: 1671 ng/mL FEUFerritin: 1929 ng/mLLDH: 439 IU/LCRP: 7.2 mg/dL | ||
| Patient 8 | 74MaleCaucasianLTCF | Hypertension, Parkinson disease, hypothyroidism | Fever, altered mental status, shortness of breath, fatigue | TEMP: 39.1°CSBP: 114 mmHgRR: 38 rpmHR: 121 bmpO2: 77% | WBC: 3.7 k/mmPCT: 38.74 ng/mlLAC: 3.8 mmol/LDD: 2589 ng/mL FEUFerritin: 1225 ng/mLLDH: 516 IU/LCRP: 46.8 mg/dL | ||
| Patient 9 | 72FemaleHispanicLTCF | Hypertension, COPD, dementia | Shortness of breath, fever, lethargy | TEMP: 38.3°CSBP: 102 mmHgRR: 45 rpmHR: 103 bmpO2: 88% | WBC: 20.3 k/mmPCT: 0.47 ng/mlLAC: 2.2 mmol/LDD: 2177 ng/mL FEUFerritin: 328 ng/mLLDH: 256 IU/LCRP: 15.1 mg/dL | ||
| Patient 10 | 82MaleBlack or African AmericanLTCF | Hypertension, dementia | Altered mental status, anorexia | TEMP: 40°CSBP: 89 mmHgRR: 24 rpmHR: 123 bmpO2: 98% | WBC: 12.7 k/mmPCT: NALAC: 3.2 mmol/LDD: NAFerritin: NALDH: NACRP: NA | ||
| Patient 11 | 74MaleCaucasianLTCF | Hypertension, T2D, COPD-asthma, overlap, CVA, dementia | Shortness of breath, cough, fever | TEMP: 38.8°CSBP: 71 mmHgRR: 22 rpmHR: 98 bmpO2: 85% | WBC: 3.5 k/mmPCT: 0.84 ng/mlLAC: 1.8 mmol/LDD: 825 ng/mL FEUFerritin: 350 ng/mLLDH: 119 IU/LCRP: 9.7 mg/dL | ||
| COPD – chronic obstructive pulmonary disease; CRP – C-reactive protein, CVA – cerebrovascular accident; D.D. – D-dimer; H.R. – heart rate; ICU – Intensive Care Unit; IV – intravenous; IVM – invasive mechanical ventilation; LAC – lactate; LDH – lactate dehydrogenase; LTCF – long-term care facility; R.R. – respiratory rate; OSA – obstructive sleep apnea, O2 – oxygen saturation; PCT – procalcitonin; SVT – supraventricular tachycardia; SBP – systolic blood pressure; T2D – type 2 diabetes, TEMP – temperature; WBC – white blood cell count. | |||||||
| Patient No. | Chest X-rays on admission | Resipratory support in the ED | Threrapy | ICU admission | IMV vaso pressors | Death | Lenght of stay (says) |
| Patient 1 | Unilateral infiltrates | None | HydroxychloroquineProphylactic heparinCeftriaxone/Doxycycline | No | No/No | No | 5 |
| Patient 2 | Bilateral infiltrates | Invasive mechanical ventilation | HydroxychloroquineProphylactic heparinCefepime/vancomycinCeftriaxone/azithromycin | Yes | Yes/Yes | Yes | 7 |
| Patient 3 | Unilateral infiltrates | Invasive mechanical ventilation | IV methylprednisoloneTherapaeutic enoxapirinPipperacillin-tazobactam | Yes | Yes/No | No | 7 |
| Patient 4 | Bilateral infiltrates | Non rebreather mask | Pipperacillin-tazobactam | No | No/No | Yes | 2 |
| Patient 5 | Bilateral infiltrates | None | IV methylprednisoloneTherapaeutic enoxapirinCeftriaxone/azithromycin | No | No/No | Yes | 6 |
| Patient 6 | Bilateral infiltrates | Invasive mechanical ventilation | IV methylprednisoloneHeparin infusionPipperacillin-tazobactamMeropenem | Yes | Yes/Yes | Yes | 19 |
| Patient 7 | Unilateral infiltrates | Nasal cannula | Prophylactic heparinCeftriaxone/doxycyclineAzithromycin | No | No/No | No | 7 |
| Patient 8 | Bilateral infiltrates | High flow nasal cannula | Prophylactic heparinPipperacillin-tazobactamAztreonamAzythromycin | No | No/No | Yes | 8 |
| Patient 9 | Unilateral infiltrates | Humidified high-flow nasal cannula | Prophylactic heparinCeftriaxone/azithromycin | No | No/No | Yes | 6 |
| Patient 10 | Unilateral infiltrates | Nasal cannula | Prophylactic heparinCefepimeCeftriaxone | No | No/No | Yes | 6 |
| Patient 11 | Bilateral infiltrates | Nasal cannula | DexomethasoneProphylactic enoxaparinCefepime/vancomycinCeftriaxone/azithromycinCefuroximeRemdesivirCetepime/metronidazole | Yes | No/Yes | No | 21 |
| COPD – chronic obstructive pulmonary disease; CRP – C-reactive protein, CVA – cerebrovascular accident; D.D. – D-dimer; H.R. – heart rate; ICU – Intensive Care Unit; IV – intravenous; IVM – invasive mechanical ventilation; LAC – lactate; LDH – lactate dehydrogenase; LTCF – long-term care facility; R.R. – respiratory rate; OSA – obstructive sleep apnea, O2 – oxygen saturation; PCT – procalcitonin; SVT – supraventricular tachycardia; SBP – systolic blood pressure; T2D – type 2 diabetes, TEMP – temperature; WBC – white blood cell count. | |||||||