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Management of COVID-19 at the pandemic's first wave in Ecuador
Killen H Briones-Claudett1,2,3, Roger Alexander Murillo Vásconez3,4, Carolina Del Rosario Rivera Salas3,4
1Faculty of Medical Sciences, University of Guayaquil, Guayaquil, Ecuador.
Insights
A physician with severe coronavirus disease 2019 (COVID-19) survived using mechanical ventilation and prone positioning. This case highlights emergent treatment strategies and the challenges faced by healthcare workers during the pandemic.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic severely impacted Ecuador in early 2020, leading to high mortality rates.
- Emerging global research influenced real-time therapeutic strategies, particularly in under-resourced healthcare settings.
Observation:
- A 59-year-old male physician in Guayaquil presented with severe COVID-19.
- The patient required mechanical ventilation, including the use of prone positioning and a pulmonary protective ventilatory strategy.
Findings:
- This case represents the first reported physician survivor of severe SARS-CoV-2 infection in Ecuador.
- The clinical management integrated evolving scientific publications and addressed self-medication concerns among healthcare professionals.
Implications:
- This case underscores the importance of adapting critical care interventions based on emerging evidence during a pandemic.
- It highlights the psychological toll on healthcare teams managing severe COVID-19 cases under extreme pressure.
- The study emphasizes the role of responsible research dissemination in guiding clinical practice in real-time.
Abstract:
During March and April 2020, Ecuador was the country with the highest death toll in Latin America due to the coronavirus disease 2019 pandemic. Simultaneously, research was being developed and published globally, and to a certain extent, guided therapeutic approaches in real time, mostly in under-resourced settings. We present the case of a 59-year-old male physician residing in Guayaquil, who presented with severe coronavirus disease 2019, in which mechanical ventilation, prone position, and pulmonary protective ventilatory strategy were used. We discuss the clinical management of the first reported case in the literature of a physician in Ecuador who survived severe acute respiratory syndrome coronavirus 2 infection, as well as the topic of self-medication within health professionals, the management approach that was emerging at the moment in scientific publications and guiding treatment, the role of responsible research and its worldwide impact, and the emotional burdens of the care team who had to make very difficult decisions in extremely adverse circumstances.
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