Vol.68 No.6 November 2020
A case of SARS-CoV-2 pneumonia complicated with acute respiratory distress syndrome treated with favipiravir
1)Division of Pulmonary Medicine, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
2)Department of Infectious Control, Showa General Hospital
3)Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA)
Abstract
A 60-year-old man was admitted to our hospital after a 7-day history of increasing fever and dry cough. Computed tomography (CT) revealed bilateral ground-glass opacities, resulting in a suspicion of coronavirus disease pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Nine days after symptom onset, the patient tested positive for SARS-CoV-2 based on a reverse transcription-polymerase chain reaction test.
The next day, the condition of the patient deteriorated; he had fever and tachypnea with worsening respiratory conditions by the hour, and the oxygen flow rate was increased from 3 L/min to 6 L/min in 8 hours.
However, favipiravir was promptly administered because the patient's respiratory conditions were worsening each hour, and 4 hours later, he needed a maximum oxygen flow rate of 8 L/min.
Tracheal intubation was also considered in case the oxygen flow rate was increased, but it was not needed. Approximately 48 hours after administration, the patient's fever began to alleviate, and the oxygen dosage was tapered.
Three days after administration, CT revealed bilateral diffuse ground-glass opacities with bronchiectasis, suggesting a diagnosis of acute respiratory distress syndrome.
The patient's fever and tachypnea normalized within a week; therefore, we inferred that 14-day favipiravir monotherapy was sufficiently good.
Based on our study, we recommend that favipiravir should be considered for treating SARS-CoV-2 pneumonia, which could stop disease progression and avoid intubation even if the patient is in a severe and deteriorating condition.
Key word
COVID-19, SARS-CoV-2, viral pneumonia, favipiravir, acute respiratory distress syndrome
Received
June 5, 2020
Accepted
September 3, 2020
Jpn. J. Chemother. 68 (6): 627-631, 2020
