Clinical Presentation of a COVID-19 Delta Variant Patient: Case Report and Literature Review

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes severe bilateral pneumonia and acute respiratory distress syndrome (ARDS) which can lead to difficulty breathing. Many cases require mechanical ventilation and intensive care unit management. The need for mechanical ventilation and ICU admission seems to be more evident in patients that were unvaccinated for COVID-19 at the time of admission. We discuss a case of a 63-year-old African-American woman who presented as a transfer to our hospital facility with acute hypoxic respiratory failure. She was already intubated and mechanically ventilated prior to her transfer. She had a one-week history of shortness of breath and cough productive of white, blood-tinged sputum. A two-day history of diarrhea was also reported before admission to the other hospital where she stayed for a week before transfer to our intensive care unit. She had no significant past medical history and was unvaccinated for COVID-19, and was suspected to be infected with the Delta strain of COVID-19. Her primary diagnosis at admission was COVID pneumonia and acute hypoxic respiratory failure. Her condition worsened over a period of one week. Chest X-Ray, at the time of arrival, showed bilateral patchy opacities consistent with COVID-19 pneumonia. After an extensive review of her labs and reports, the patient was attributed to be at a high risk for acute decompensation (or catastrophically ill), thus requiring critical care management. Over a course of 12 days, she was aggressively treated with antibiotics, steroids, remdesivir and tocilizumab. Her condition gradually deteriorated and she eventually passed away. It can be noted that most of the severe cases, especially ICU admissions, comprise people who are unvaccinated. We can safely conclude that although vaccination may not prevent re-infection, it does result in better clinical outcomes.

COVID-19-related thrombotic complications experience before and during delta wave

“…The emergent concept of the VOC, the recent surge of COVID-19 cases in summer 2021, and the need for further information on the behavior of these new genotypes motivated a subgroup analysis in the patients admitted during the estimated time of COVID-19 Delta variant spike. This variant was reported as more transmissible and prevalent in the Southeastern US region due to the low vaccination levels ( 21 ), reinforcing the relevance of describing the outcomes secondary to this mutation.…”

Immune, inflammatory and prothrombotic parameters in COVID-19 patients treated with an anti EGFR antibody

“…These mutations have led the virus to become more transmissible than previous variants. This variant also causes more severe disease, has a significant higher risk of hospitalization, intensive care unit admission, pneumonia developing and about 137% greater risk of death compared to non-delta SARS-CoV-2 [18] .…”

Recapping the Features of SARS-CoV-2 and Its Main Variants: Status and Future Paths

“…Moreover, there has been higher hospital admission or emergency care attendance risk for patients with COVID-19 infected with the Delta variant compared to those affected with the Alpha variant, as well as an increased transmissibility [ 110 , 111 ]. Fortunately, early diagnosis and a full vaccination routine could protect patients from severe disease progression [ 112 , 113 ]. In vitro, B.1.617.2 has been shown to be 6-fold less sensitive to serum neutralizing antibodies from recovered individuals, and 8-fold less sensitive to vaccine-elicited antibodies, compared with wild-type SARS-CoV-2.…”