12 April 2022: Articles
A Case of Rebound Inflammation in a 38-Year-Old Man with Severe COVID-19 Pneumonia Following Cessation of Dexamethasone Therapy
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Clinical situation which can not be reproduced for ethical reasons
Hoa Tran * , Vu Hoang Vu * , Toan Thanh Phan A , Khang Duong Nguyen E* , Binh Quang Truong ADOI: 10.12659/AJCR.935946
Am J Case Rep 2022; 23:e935946
Table 1. Laboratory findings during hospitalization, which first demonstrated lower inflammatory marker concentrations (days 1–3), but subsequently increased at day 7, and eventually declined following corticosteroid re-initiation.
| Day 1 | Day 3 | Day 7 | Day 10 | Day 12 | Day 14 | Day 16 | Day 18 | Day 21 | |
|---|---|---|---|---|---|---|---|---|---|
| Urea (mg/mL) | 23.97 | 30.56 | 37.75 | 22.17 | 19.77 | 33.56 | 29.36 | 37.75 | |
| Creatinine (mg/mL) | 0.97 | 0.78 | 0.75 | 0.73 | 0.62 | 0.71 | 0.6 | 0.69 | |
| Na+ (mEq/L) | 137 | 141 | 136 | 137 | 137 | 136 | 137 | 137 | 136 |
| K+ (mEq/l) | 4.5 | 3.66 | 4.01 | 3.97 | 3.99 | 3.82 | 4.06 | 3.84 | 3.63 |
| CL- (mEq/l) | 103 | 107 | 101 | 101 | 101 | 99 | 103 | 100 | 100 |
| CRP (mg/L) | 139 | 34.6 | 10.5 | 1.4 | 24.8 | 4.6 | 1.3 | 0 | |
| PCT (ng/mL) | 0.176 | 0.08 | 0.08 | 0.04 | 0.94 | ||||
| D-dimer (mg/L) | 4083 | 593 | 675 | 425 | 304 | ||||
| Fibrinogen (g/L) | 7.4 | 6.42 | 4.72 | 6.37 | 5.31 | 4.05 | |||
| WBC (G/L) | 15.21 | 11.72 | 17.52 | 14.52 | 12.21 | 12.16 | 11.7 | 10.45 | 11.3 |
| Neu (G/L) | 14.65 | 10.81 | 16.19 | 11.64 | 10.14 | 9.91 | 10.3 | 8.59 | 9.5 |
| LYM (G/L) | 0.42 | 0.59 | 0.76 | 2.03 | 1.33 | 1.43 | 1.16 | 1.58 | 1.44 |
| RBC (T/L) | 4.65 | 4.4 | 4.96 | 4.75 | 4.76 | 4.87 | 4.64 | 4.92 | |
| Hb (g/dl) | 139 | 131 | 149 | 142 | 145 | 137 | 137 | 140 | |
| PLT (G/L) | 491 | 497 | 439 | 481 | 412 | 391 | 354 | 348 | 409 |
| LDH (U/L) | 487.72 | 400.03 | 381.28 | 304.07 | 294.27 | 242.94 | 269.47 | ||
| Ferritin (ng/L) | 633.32 | 414.52 | 688.06 | 655.54 | 802.16 | 740.51 | 656.37 | ||
| IL-6 (pg/mL) | 11.6 | 5.36 | 12.8 | 9.01 | 12.85 | 1.84 | 3.29 | ||
| PCR CT value | 25.6 | 30 | 34.3 | 35.2 | |||||
| PCR CT value – real-time polymerase chain reaction test and cycle threshold values for SARS-CoV-2. | |||||||||