A case report on a severely ill COVID-19 patient with rapid clearing of chest infiltrates 43 hours after treatment with multiple modalities

A 44-year-old COVID-19 positive patient was transferred to our hospital with worsening acute hypoxemic respiratory failure. She was admitted to ICU and was started on high flow oxygen. Her CXR showed worsening bilateral infiltrates. In order to prevent her progression from severe to critical disease, we adopted a multiple modality treatment approach, utilizing clinical judgment and most recent publications. She was treated with antibiotics, convalescent plasma, steroids, hydroxychloroquine and self-proning. After 43 hours, her CXR showed rapid clearing of infiltrates and we could discharge her on day three of hospitalization. Previously reported case series on convalescent plasma showed the number of days taken for significant improvement in chest x-ray varied from 4 to 7 days. The rapidity of improvement in this patient is remarkable and could be due to the multiple modality treatment approach.