COVID-19 Treatment in Medan, Indonesia: A Case Report

In the past decades, two known zoonotic coronaviruses, SARS-CoV and MERS-CoV, have been reported to damage the respiratory tract and cause severe outbreaks. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly discovered coronavirus, which was first discovered in Wuhan, China in December 20191. Coronaviruses are enveloped, positive single-strandedlarge RNA viruses that infect humans, but also a widerange of animals. Coronaviruses were first described in 1966 by Tyrell and Bynoe, who cultivated the viruses from patients with common colds2 SARS-CoV-2, which belongs to a unique clade of the Sarbecovirus subgenus of the Orthocoronavirinae subfamily, was identified as the pathogen of Coronavirus disease 2019 (COVID-19) in January 2020 3. A majority (67-85%) of critically ill patients admitted in intensive care units with confirmed infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) developed the acute respiratory distress syndrome (ARDS)4 The maximum incubation period is assumed to be up to 14 days, whereas the median time from onset of symptoms to intensive care unit (ICU) admission is around 10 days. Recently, WHO reported that the time between symptom onset and death ranged from about 2 weeks to 8 weeks5. The severity of patient?s symptoms was categorized as mild, severe, or critical. Mild included non-pneumonia and mild pneumonia cases. Severe was characterized by dyspnea, respiratory frequency ?30/minute, blood oxygen saturation ?93%, PaO2/FiO2ratio <300, and/or lung infiltrates >50% within 24?48hours. Critical cases were those that exhibited respiratory failure, septic shock, and/or multiple organ dysfunction/failure6,7