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Case Reports
. 2023 Jul 18;11(7):e7710.
doi: 10.1002/ccr3.7710. eCollection 2023 Jul.

Ethical conflicts associated with COVID-19 pandemic, triage and frailty-unexpected positive disease progression in a 90-year-old patient: A case report

Andreas Wehrfritz  1 , Joachim Schmidt  1 , Frank Bremer  1 , Anne-Katharina Lang  1 , Jacob Welzer  2 , Ixchel Castellanos  1
Affiliations
Case Reports

Ethical conflicts associated with COVID-19 pandemic, triage and frailty-unexpected positive disease progression in a 90-year-old patient: A case report

Andreas Wehrfritz et al. Clin Case Rep. .

Abstract

During the COVID 19 pandemic, advanced age, scoring systems, and a shortage of ICU beds were used as cut-offs for ICU admission. This case report describes the epicrisis of an elderly patient who was almost mistakenly not treated in an ICU.

Keywords: COVID‐19; aged patient; ethical dilemma; triage and frailty; unexpectedly positive trend.

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Conflict of interest statement

The authors declare that they have no financial or personal conflicts of interest associated with this case report.

Figures

FIGURE 1
FIGURE 1
Chest radiography showed Covid‐19 typical bipulmonary infiltrates, which already occupied 70% of the patient's lung parenchyma. Chest radiography showed bipulmonary infiltrates typical of Covid‐19, which affected 70% of the lung parenchyma of the 90‐year‐old patient already on the day of admission to the ICU (day 2).
FIGURE 2
FIGURE 2
Development of C reactive protein values during hospitalization. C reactive protein (CRP) measurement in nmol/l shown on the y‐axis over the individual days (x‐axis), starting with the first day of hospitalization. Initiation of antibiotic therapy with piperacillin/tazobactam on Day 5, initiation of therapy with linezolid on Day 14.
FIGURE 3
FIGURE 3
Development of procalcitonin values during hospitalization. Procalcitonin (PCT) measurement in μg/l shown on the y‐axis over the individual days (x‐axis), starting with the first day of hospitalization. Initiation of antibiotic therapy with piperacillin/tazobactam on Day 5, initiation of therapy with linezolid on Day 14.
FIGURE 4
FIGURE 4
Development of urea levels during hospitalization. Measurement of urea in mmol/l on the y‐axis, charted over the individual days (x‐axis), starting with the first day. Sufficiency calculated fluid therapy until Day 5. Thereafter, renewed increase with subsequent dialysis requirement from Day 13 to 18.
FIGURE 5
FIGURE 5
Development of creatinine values during hospitalization. Measurement of creatinine in μmol/l on the y‐axis, plotted over the individual days (x‐axis), starting with the first day. Sufficiency calculated fluid therapy until Day 5. Thereafter, renewed increase with subsequent dialysis requirement from Day 13 to 18.
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