Protracted course of coronavirus disease with severe acute respiratory distress syndrome: a case report

BACKGROUND: Coronavirus disease (COVID‐19) is a growing concern worldwide. Approximately 5% of COVID‐19 cases require intensive care. However, the optimal treatment for respiratory failure in COVID‐19 patients is yet to be determined. CASE PRESENTATION: A 79‐year‐old man with severe acute respiratory distress syndrome due to COVID‐19 was admitted to our intensive care unit. Prone ventilation was effective in treating the patient’s hypoxemia. Furthermore, the patient received lung protective ventilation with a tidal volume of 6–8 mg/kg (predicted body weight). However, the patient’s respiratory failure did not improve and he died 16 days after admission because of multiple organ failure. Serial chest computed tomography revealed a change from ground‐glass opacity to consolidation pattern in both lungs. CONCLUSIONS: We report a protracted case of COVID‐19 in a critically ill patient in Japan. Although prone ventilation could contribute to treating hypoxemia, its efficacy in preventing mortality from COVID‐19 is unknown.