[Covid19 in a polypathological subject]

In December 2019, an outbreak of pneumonia due to the 2019 novel coronavirus, SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), broke out in Wuhan, Hubei, China. This betacoronavirus causes a sometimes severe respiratory pathology, named COVID-19 by the World Health Organization (WHO). The WHO declared COVID-19 as a pandemic in March 2020. It is Mrs. RM, 71 years old of French nationality who consults for dyspnea on exertion for 8 days associated with a dry cough, an intermittent fever with periods of spontaneous remissions, a chest pain accentuated by the efforts of cough, a physical asthenia, non-selective anorexia, diarrhea and vomiting. The physical examination found respiratory distress with 72% desaturation in ambient air, requiring oxygen-requisition with 96% oxygen saturation under 10 liters with no sign of respiratory struggle; crackling rales with 2 more predominant lung fields on the right, mucocutaneous jaundice, edema of the lower limbs. The management was intubation upon admission with mechanical ventilation, oral administration of hydroxychloroquine 200 mg due to 2 tablets morning and evening for 24 hours then 1 tablet morning and evening for 04 days, antibiotic therapy based on ceftriaxone 1g morning and evening was implemented, in the absence of bacteriological evidence. The course was unfavorable with a death with the absence of clinical improvement and a very precarious hematosis escaping any treatment alternative.

Covid19 is a very serious virus with a poor prognosis in multiple pathological patients.