24 February 2025
: Case report 
Severe COVID-19 Pneumonia, Opportunistic Candida krusei Infection, and Acute Respiratory Distress Syndrome with Pulmonary Arterial Hypertension Treated with Bosentan: A Case Report
Unusual clinical course, Management of emergency care
Killen H. Briones-Claudett
123ABCDEFG*, Killen H. Briones-Zamora 24ABCDEFG, Jaime Galo Benites Solis 34ACDEFG, Doménica I. Huilcapi Borja 4ABCDEFG, Karelys Nicole Arteaga Ocaña 4ABCDEFG, Maria Antonieta Touriz Bonifaz5BCDEFG, Pedro Barberan-Torres 1BCDEFG, Michelle Grunauer 6BCDEFG
DOI: 10.12659/AJCR.946400
Am J Case Rep 2025; 26:e946400
Table 1. Sequential cardiac function and bosentan therapy monitoring. Chronological documentation of cardiac parameters and therapeutic adjustments, including pulmonary pressures, ventricular measurements, and bosentan dosing strategy.
| Day | Event | Ejection fraction (%) | Right ventricular diameter (mm) | PASP (mmHg) | Bosentan (mg) |
|---|---|---|---|---|---|
| 1 | Admission and initial assessment | 64 | 28 | 36 | – |
| 2 | Deterioration and change in support | 61 | 36 | 45 | – |
| 6 | Initiation of invasive mechanical ventilation | 59 | 38 | 70 | – |
| 7 | Continued invasive mechanical ventilation | 59 | 38 | 55 | 125 |
| 9 | Weaning from invasive mechanical ventilation | 62 | 37 | 54 | 125 |
| 10 to 15 | After extubation | 61 | 35 | 40 | 125 |
| 20 | Further improvement | 62 | 36 | 40 | 62.5 |
| 26 | Discontinuation of bosentan | 61 | 36 | 45 | 62.5 |
| 30 | Initiation of pulmonary rehabilitation | 69 | 34 | 38 | – |
| 51 | Discharge from hospital | 67 | 31 | 28 | – |