Extremely Severe Case of COVID-19 Pneumonia Recovered Despite Bad Prognostic Indicators: a Didactic Report

Abstract

COVID-19 is a highly infectious respiratory disease caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Starting from Wuhan (China) where it was firstly reported, it rapidly spread to the rest of the world, causing a pandemic with more than 300,000 deaths to date. We report an extremely severe case of coronavirus pneumonia in an over 80-year-old patient with hypertension, coronary heart disease, chronic heart failure, and chronic obstructive pulmonary disease. Despite a clearly poor anamnestic and clinical prognostic forecast, she was successfully discharged thanks to a careful evaluation of the case and of the complications that have arisen. Although a higher vulnerability of geriatric patients has been observed, the literature on elderly COVID-19 patients has remained very scarce, especially in those over 80. The article aims to explore factors that may allow the successful outcome and provides important elements to better understand this disease.

Keywords: Covid-19; Imaging; Prognosis; SARS-CoV-2.

Fig. 1

First HRCT showing ground glass and “crazy paving” pattern areas and large areas of parenchymal consolidation with air bronchogram

Fig. 2

First HRCT showing ground glass and “crazy paving” pattern areas and large areas of parenchymal consolidation with air bronchogram

Fig. 3

First HRCT showing ground glass and “crazy paving” pattern areas and large areas of parenchymal consolidation with air bronchogram

Fig. 4

Second HRCT showing important reduction of ground glass and consolidation areas with onset of reticular pattern and fibrosis

Fig. 5

Second HRCT showing important reduction of ground glass and consolidation areas with onset of reticular pattern and fibrosis glass

Fig. 6

Second HRCT showing important reduction of ground glass and consolidation areas with onset of reticular pattern and fibrosis