Clinical data on coronavirus disease 2019 (COVID-19) with pancreatic injury are extremely limited. An acute manifestation of acute pancreatitis in COVID-19 has not been reported. We describe here two cases of COVID-19 with acute pancreatitis as the initial manifestation in Wuhan, China. Patient one died despite maximal mechanical ventilatory support and circulation support, while patient two was finally discharged after showing significant improvement. Low T cells in peripheral blood may indicate a poor outcome.
Introduction: Since the coronavirus disease 2019 (COVID-19) outbreak in Wuhan in late 2019, controversy on the use of corticosteroids for COVID-19 has obtained increasing attention. We present 1 critically ill patient who had a rapid therapeutic response to moderate-dose corticosteroids. Patient concerns: A 53-year-old critically ill woman from Wuhan suffered with COVID-19. Diagnosis: The chest computed tomography scan was suggestive of COVID-19. The diagnosis was confirmed by a real-time reverse transcription polymerase chain reaction test for SARS-CoV-2. The critically ill status was characterized by worsening dyspnea, progressing bilateral lung consolidation, and poor oxygenation (SiO 2 /FiO 2 :110 mm Hg). Interventions: The patient was treated with a moderate dose of intravenous corticosteroids and high-flow nasal cannula oxygen therapy. Outcomes: After the initiation of corticosteroids, the patient rapidly improved over the following 6 days. Serial chest computed tomography scans showed good absorption of the consolidations. The patient was discharged on Day 17 of hospitalization without obvious adverse effects. Conclusions: Early use of moderate-dose corticosteroids over a short period may enhance recovery from COVID-19 in critically ill patients.
We report the clinical characteristics, viral shedding duration, and contact tracing for asymptomatic carriers of SARS-CoV-2 in Wuhan, China. The asymptomatic carriers were relatively young (median age: 34.5 years). Chest computed tomography showed no abnormalities. The nasopharyngeal swab was an optimum specimen for RNA testing. The median viral shedding duration was 11.5 days. Notably, 2 months of viral shedding duration were reported in two nurses, which was much longer than previously reported or than usually thought. The transmissibility of SARS-CoV-2 by asymptomatic carriers during the studied period in Wuhan appeared to be weak. Only one patient (1/12) was found to have transmitted the virus to another person. Early asymptomatic carrier detection, isolation, and contact tracing could be useful to mitigate the spread of the disease.
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