Case 250

 We presented a seventy seven-year-old male suffering from fever (38℃), throat pain and nasal fluids. Antigen test of SARS-CoV-2 was positive. He had previously undergone stent treatment for abdominal aortic dissection and stenosis of left internal carotid artery. Four days after the onset (Day 4), he was admitted to our hospital and received chest CT (Fig.1). He discharged our hospital fifteen days later (Day 15). During his stay, he did not experience hypoxia. However, twenty six days after the onset (Day 26), chest CT showed worsening of the shadow (Fig. 2). Thirty days after the onset (Day 30), he was re-admitted to our hospital for hypoxia. Although he received artificial respirator, steroid pulse treatment and immunosuppressive medicine, CT shadow worsened (Figs. 3, 4). Regrettably, he passed away fifty one days later after the onset (Day 51).
 Laboratory test on the day after the onset, white blood cells counts/mm3, lymphocytes (%, counts/mm3) are; Day 4, 4100, 19%, 779; Day 23, 6060, 11.4%, 690; Day 26, 5480, 10.7%, 586; Day 32, 7540, 7.9%, 595; Day 37, 10760, 5.3%, 570; Day 39, 13100, 5.0%, 655; Day 41, 12110, 7.1%, 859; Day 42, 17190, 3.0%, 515; Day 43, 20350, 1.6%, 325; Day 44, 19480, 1.1%, 214; Day 45; 19110, 1.8%, 343: Day 46, 19250, 1.7%, 327. Day 49, he passed away.

What are the factors of high risk for COVID19 ?

1.　LDH

2.　KL6

3.　Neutrophils

4.　Lymphopenia

5.　all

answer

2021.11.22