SURVIVING AGAINST ALL ODDS: A CASE OF MULTI-ORGAN FAILURE IN THE SETTING OF COVID-19

TYPE: Late Breaking Case Report TOPIC: Critical Care INTRODUCTION: COVID-19 is a novel virus and our understanding of the infection is still evolving. Even though may remain asymptomatic, severity of disease can vary from mild symptoms to multi-organ failure. We report an African-American female who survived severe multi-organ failure secondary to COVID-19. CASE PRESENTATION: 67-year old female with a past medical history significant for coronary artery disease was admitted to the ICU with respiratory failure requiring intubation and mechanical ventilation secondary to COVID-19 pneumonia. Her course was complicated by renal failure requiring renal replacement therapy. She developed septic shock requiring pressors, PEA cardiac arrest requiring advanced cardiac life support, disseminated intravascular coagulopathy, and upper gastrointestinal bleed. She received 30 units of packed red blood cells and multiple platelet and cryoglobulin transfusions. She also developed recurrent episodes of sustained bradycardia and sinus pauses for up to 1 minute, thus requiring a pacemaker. She underwent tracheostomy and percutaneous endoscopic gastrostomy tube placement. She was discharged to a subacute rehabilitation facility where she was successfully liberated from the ventilator. She is home and fully independent of her activities of daily living. DISCUSSION: Anticipated clinical course for this patient was initially grim as she endured a very complicated hospital course. The case demonstrated the difficult prognostication of COVID-19, especially in the setting of being a novel disease. CONCLUSIONS: Mortality for patients on prolonged mechanical ventilation is very high; however, without prior knowledge of COVID-19 and its long term effects, it is important to understand the potential for full recovery even against all odds as this case illustrates. DISCLOSURE: Nothing to declare. KEYWORD: covid