Hyperpyrexia leading to death in a patient with severe COVID-19 disease

  1. Tanu Singhal
  2. Sourabh Phadtare
  3. Sunil Pai
  4. Amit Raodeo

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Abstract

We describe here the clinical course of a 42 year old male with severe COVID 19 disease treated at a private hospital in Mumbai, India. This patient with very high inflammatory markers at admission was treated with supportive care, mechanical ventilation, anticoagulation, hydroxychloroquine, corticosteroids, tocilizumab, intravenous insulin, antibiotics, sedation and paralysis. There was sustained improvement in his respiratory status and decline in ventilator settings with decline and normalization of CRP, D dimer and PCT. However high fever persisted that did not respond to paracetamol and NSAIDS. On day 8 of admission his axillary temperature touched 107F followed by rapid clinical deterioration and death within the next 12 hours, Blood cultures were consistently sterile. While death was related to hyperpyrexia, the cause of this hyperpyrexia is uncertain.

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  1. ScreenIT

    SciScore for 10.1101/2020.05.18.20097220: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  2. Version published to 10.1101/2020.05.18.20097220v1 on medRxiv