The first case of a COVID 19 patient with acute respiratory distress syndrome (ARDS) who recovered early following the IV administration of high-dose vitamin C was published in the American Journal of Case Reports. About the case: A 74-year-old woman presented to the emergency department with fever, cough, and shortness of breath. She had no recent sick contacts or travel history. The vital signs were normal except for oxygen saturation of 87% and bilateral rhonchi on lung auscultation. Chest radiography revealed air space opacity in the right upper lobe, suspicious for pneumonia. A nasopharyngeal swab for severe acute respiratory syndrome coronavirus-2 came back positive while the patient was in the airborne-isolation unit. Laboratory data showed lymphopenia and elevated lactate dehydrogenase, ferritin, and interleukin-6. The patient was initially started on oral hydroxychloroquine and azithromycin. On day 6, she developed ARDS and septic shock, for which mechanical ventilation and pressor support were started, along with the infusion of high-dose intravenous vitamin C. The patient improved clinically and was able to be taken off mechanical ventilation within 5 days. Takeaways: The case report highlights the potential benefits of high-dose intravenous vitamin C in critically ill COVID-19 patients in terms of rapid recovery and shortened length of mechanical ventilation and ICU stay.
Vitamin C is an antioxidant, which means that it can fight oxidative damage. When the immune system activates to kill a pathogen, it may also cause oxidative damage. This suggests that vitamin C could fight the damage that the disease-fighting process causes.
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These are rare incidences but encouraging We all know how vit c is essential in life for defending immunity Good presentation
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40yrs/F presented to ED with C/o Severe Respiratory distress and altered mental status.Patient started noticing symptoms 5 days after operated for hysterectomy (Uterine fibroid) at some other hospital.Emergently intubated after acute respiratory failure,patient had to be deeply sedated and paralysed. O/e - Crackles and wheezes,BP -140/80,PR -72,Spo2 -98,Temp -103°F. DIAGNOSIS AND SUGGEST MANAGEMENT PLAN?
Dr. Prashant Vedwan6 Likes24 Answers - Login to View the image
30hrs newborn male child having severe respiratory distress with feeble peripheral pulse. H/0 TERM/AGA/NVD/SBA. VITALS- HR-157/min, RR->85/min, SPO2-74-76%with O2. We intubate the child and put on high frequency ventilation. Inotropic support dopamine, dobutamine, adr. , With antibiotics Mero+Amika and IVF nd calcium gluconate and anticonvulsants. Inj vit.k od for 5days and FFP transfusion done. Adv Management and DDX
Dr. Sunil Yadav0 Like9 Answers - Login to View the image
CXR is from a patient with Miliary Tuberculosis. How to proceed with the case?
Dr. Narendra Kumar2 Likes8 Answers - Login to View the image
The world is currently suffering from the outbreak of a pandemic caused by the severe acute respiratory syndrome coronavirus SARS-CoV-2 that causes the disease called COVID-19, first reported in Wuhan, Hubei Province, China on 31 December 2019. The most common comorbidities in one report were hypertension (30%), diabetes (19%), and coronary heart disease (8%). Another report showed that the most frequent comorbidities in patients with COVID-19 who developed the acute respiratory distress syndrome were hypertension (27%), diabetes (19%), and cardiovascular disease (6%). The frequency with which COVID-19 patients are hypertensive is not entirely surprising nor does it necessarily imply a causal relationship between hypertension and COVID-19 or its severity, since hypertension is exceedingly frequent in the elderly, and older people appear to be at particular risk of being infected with SARS-CoV-2 virus and of experiencing severe forms and complications of COVID-19. It is unclear whether uncontrolled blood pressure is a risk factor for acquiring COVID-19, or whether controlled blood pressure among patients with hypertension is or is not less of a risk factor. However, several organizations have already stressed the fact that blood pressure control remains an important consideration in order to reduce disease burden, even if it has no effect on susceptibility to the SARS-CoV-2 viral infection. In conclusion, there is as yet no evidence that hypertension is related to outcomes of COVID-19, or that ACE inhibitor or ARB use is harmful, or for that matter beneficial, during the COVID-19 pandemic. Use of these agents should be maintained for the control of blood pressure, and they should not be discontinued, at least on the basis of current evidence at this time. To read more-https://academic.oup.com/ajh/advance-article/doi/10.1093/ajh/hpaa057/5816609
Dr. Somesh Sharma4 Likes2 Answers - Login to View the image
Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China In December 2019, novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited. Objective To describe the epidemiological and clinical characteristics of NCIP.. Main Outcomes and Measures Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked. Result- Common symptoms included fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]). Lymphopenia (lymphocyte count, 0.8 × 109/L [interquartile range {IQR}, 0.6-1.1]) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients (39.9%). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 [61.1%]), arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Conclusion- In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%. To read more click- https://jamanetwork.com/journals/jama/article-abstract/2761044 Source-JAMA Authors- Dawei Wang, MD; Bo Hu, MD; Chang Hu, MD; et al
Dr. Pushker Mehra14 Likes5 Answers
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