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SESSION TITLE: Medical Student/Resident Chest Infections Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Novel Coronavirus (SARS-CoV-2) is the cause of the largest pandemic in over a century Initial reports from China stated that increased age and underlying commodities were the main risk factors for disease severity and mortality Increasing evidence has shown that in the US, a younger population without significant underlying disease, can also suffer from SARS-CoV-2 pneumonia with variable severity CASE PRESENTATION: We present the characteristics of 9 patients (6 male), ranging in age from 30-49y, admitted at our community hospital in March 2020 with confirmed diagnosis of SARS-CoV-2 The most common chief complaints were shortness of breath, cough, fever and abdominal discomfort The average length of stay was 7 67 days, with one patient still admitted to our facility None of the patients presented in this series were active or ex-smokers Hypertension was present only in 2 and diabetes mellitus 2 in 3 of our patients End stage renal disease was present in one of our patients Abnormal body mass index was found in 6 of 9: 2 obese, 2 overweight and 2 underweight 8 patients had hypoxemia on admission In terms of respiratory support: one patient required BIPAP and was subsequently intubated, another required high flow nasal cannula (HFNC), while the rest were managed with oxygen via nasal cannula Regarding the labs our findings were: 3/9 with leukopenia and 3/9 with leukocytosis at the time of admission Lymphopenia was found in 5/9 of our patients Increased liver enzymes were found in 5/9 of our patients D-dimer was not routinely obtained but one patient presented with an extremely elevated and up-trending D-dimer All patients received antibiotics, the two most commonly used were ceftriaxone and azithromycin along with hydroxychloroquine Chest x-ray (CXR) consistently showed bilateral patchy infiltrates that were not correlated with the clinical picture 2 patients, with PMH of only (specific PMH for the two that died) required admission to the Intensive Care Unit (ICU) and subsequently expired The other 7 were discharged successfully DISCUSSION: Younger patients in the US seem to be at increased risk of developing symptoms from COVID-19 infection Clinical scenarios can range from mild vague symptoms to severe pneumonia with ARDS CXR findings are often discordant with symptoms or with clinical improvement Elevation of liver function tests is well documented in SARS-CoV-2, and can be the only result that is abnormal, as in one of our patients Patients with severe SARS-CoV-2 pneumonia with ARDS required a prolonged hospital stay Mortality in this age group doesn\'t correlate well with the presence of commodities CONCLUSIONS: Young adults present with highly variable severity of SARS-CoV-2 infection The clinical picture is often discordant with CXR and laboratory findings Reference #1: Phelan AL, Katz R, Gostin LO The novel coronavirus originating in Wuhan, China: challenges for global health governance JAMA 2020;published online Jan 30 DOI:10 1001/jama 2020 1097 Reference #2: Wang D, Hu B, Hu C, et al Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China JAMA 2020;published online Feb 7 DOI:10 1001/jama 2020 1585 Reference #3: Xu Z, Shi L, Wang Y, et al Pathological findings of COVID-19 associated with acute respiratory distress syndrome Lancet Respir Med 2020;published online Feb 18 https://doi org/10 1016/ S2213-2600(20)30076-X DISCLOSURES: No relevant relationships by Maria Bernal Riera, source=Web Response No relevant relationships by Momcilo Durdevic, source=Web Response No relevant relationships by Dragana Durdevic, source=Web Response No relevant relationships by Amrah Hasan, source=Web Response No relevant relationships by Stephen Jesmajian, source=Web Response
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