Early manifestation of ARDS in COVID-19 infection in a 51- year-old man affected by Mounier-Kuhn syndrome.
Ramezan Jafari, Luca Cegolon, Fatemeh Dehghanpoor and 5 others
PMID 32425272WHAT IT FOUND
A patient with rare airway dilation developed early ARDS from COVID-19, then oxygen saturation fell, and he needed intubation, ICU care, ventilation, and tracheostomy before discharge after about two weeks.
It is a case report, not a treatment effect.
Key findings
01CT showed trachea 39 mm, right main bronchus 30 mm, left main bronchus 26 mm, with bilateral ground-glass opacities and bronchiectasis compatible with early ARDS.
02In a few hours the patient became cyanotic, had altered mental status, and oxygen saturation dropped to about 45%.
03The patient was intubated, transferred to the ICU, placed on oxygen therapy mechanical ventilation, had a tracheostomy, improved, and was discharged after about two weeks.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It is a single case, so it cannot show how common this course is or whether any treatment caused improvement. The patient received intubation, ICU transfer, oxygen therapy mechanical ventilation, and tracheostomy together, so their individual contributions cannot be separated. The paper reports no comparison group, randomisation, or blinding. It does not report longer-term outcomes after discharge. The CT airway measurements are from one patient, and the paper notes considerable variation in airway enlargement in Mounier-Kuhn syndrome.
The easy way to misread this
Do not conclude that Mounier-Kuhn syndrome predicts severe COVID-19 or that intubation, ICU transfer, oxygen therapy mechanical ventilation, and tracheostomy caused the improvement. This is a single case, and the contribution of any component cannot be separated.