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Case Report: The First Case of COVID-19 in Bhutan.
LeVine, Shankar; Dhakal, Guru Prasad; Penjor, Tshering; Chuki, Pem; Namgyal, Kesang; Watts, Melanie.
  • LeVine S; Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB), Thimphu, Bhutan.
  • Dhakal GP; Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB), Thimphu, Bhutan.
  • Penjor T; Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB), Thimphu, Bhutan.
  • Chuki P; Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB), Thimphu, Bhutan.
  • Namgyal K; Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB), Thimphu, Bhutan.
  • Tshokey; Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB), Thimphu, Bhutan.
  • Watts M; Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB), Thimphu, Bhutan.
Am J Trop Med Hyg ; 102(6): 1205-1207, 2020 06.
Article in English | MEDLINE | ID: covidwho-602003
ABSTRACT
The initial cases of novel coronavirus disease-19 (COVID-19) in a country are of utmost importance given their impact on healthcare providers, the country's preparedness response, and the initial molding of the public perception toward this pandemic. In Bhutan, the index case was a 76-year-old immunocompromised man who had traveled from the United States and entered Bhutan as a tourist. He presented initially with vague gastrointerestinal symptoms and later a cough. His atypical presentation led to a delay in diagnosis, but ultimately he was isolated and tested. On confirming the diagnosis of COVID-19, the patient was isolated in a separate hospital with a dedicated medical care team. All contacts were traced and quarantined. The patient's respiratory status deteriorated despite broad-spectrum antivirals, antibiotics, and intensive supportive care. He required intubation and was given a trial of intravenous immunoglobulin to modulate his likely aberrant immune response. Subsequently, the patient's clinical status improved, and after 8 days of hospitalization, he was transferred out of the country, where he recovered. This was a learning experience for the treating medical staff, the government, and the people of Bhutan.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus / Hyperlipidemias / Hypertension / Lung Type of study: Case report / Diagnostic study / Prognostic study / Randomized controlled trials Country/Region as subject: North America / Asia Language: English Journal: Am J Trop Med Hyg Year: 2020 Document Type: Article Affiliation country: Ajtmh.20-0259

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus / Hyperlipidemias / Hypertension / Lung Type of study: Case report / Diagnostic study / Prognostic study / Randomized controlled trials Country/Region as subject: North America / Asia Language: English Journal: Am J Trop Med Hyg Year: 2020 Document Type: Article Affiliation country: Ajtmh.20-0259