Experience in handling COVID-19 patients in remote areas and limited resources

Abstract

Coronavirus-19 (COVID-19) has been declared a world pandemic by WHO. District hospital had several challenges to manage this disease. The limited capacity of existing inpatient rooms, limited medical personnel, no intensive care settings, limited isolation rooms, incomplete laboratory equipment, and no radiology services available make the disease management become challenging. The following reported a case of a COVID-19 patient who was treated in limited facilities. A 49-year-old male patient presented with complaints of breathlessness. The shortness of breath occurring since six days before hospital admission. Shortness of breath comes slowly, got worse with activity, and relieved with rest. High fever was felt since six days before admission to hospital. The cough also found with whitish sputum. The patient's lips turned to be bluish. Patient also felt pain in throat. Rapid COVID-19 test found reactive on IgM. From the COVID-19 Early Warning Score (COVID-19 EWS), the score was 13. The initial diagnosis was pneumonia, with suspicion of COVID-19. Polymerase chain reaction (PCR) swab examination was undergone. In the fourth day of treatment, the result of the swab was positive. Patients diagnosed with COVID-19, by confirmation of PCR. Patients are given fluid therapy, oxygenation, broad-spectrum antibiotics, and antipyretics for 5 days. After fourteen days, the swab test was repeated and the results were negative. The patient was discharged in a good condition. This case report illustrated that the handling of COVID-19 case could be done in limited facilities and infrastructure.