Dear editor,
I am a professor and attending pharmacist in the field of pharmaceutical
sciences and writer or co-author of at least 5 manuscripts about
different aspects of COVID-19 pharmacotherapy
[1-3]. More than 15 months from the
first report of COVID-19, over 120 million people all over the world
infected by this virus, and more than 2.5 million of them have died.
Although different treatment approaches have been proposed but
management of the COVID-19 patients is steal remained controversial. In
this regard, I want to share my personal experience from the exposure to
the coronavirus and the consequence of this infection on my health
status. I am a 51 years old male, known case of hypertension,
dyslipidemia, and chronic kidney disease (stage 2 CKD-EPI). During
working hours of colleagues in the Faculty of Pharmacy, I visited one of
my colleagues in his office for 30 minutes. During this conversation
both of us wore three-layer medical mask, the widow and door of the room
were opened and at least 2-meter distance between us was regarded. After
leaving the Faculty, my colleague declares that his RT-PCR test of
COVID-19 is positive. It took 3 days for me to experience the first sign
of the COVID-19 as fever. In this regard, I isolated myself from the
other family members including my wife and my son. Other signs of the
disease including arthralgia, myalgia, headache, GI symptoms also appear
during this period on day 5th from the exposure to the
COVID-19 positive case. Nausea was persistent, especially in the
morning. I had an RT-PCR test on day 5th after
exposure and the result was positive. During the follow-up of the
disease within the Shahid-Faghihi Hospital as a referral center for
COVID-19 patients, a high-resolution computed tomography (HRCT) scan of
the lung was performed but no considerable involvement of the lung was
seen (Fig. 1.A) but pulse oximetry revealed that the PO2 saturation rate
is about 93% at the same day. In this regard, consulting with
infectious disease subspecialist and his recommendation, favipiravir was
scheduled with a loading dose of 1600 mg bid and maintenance dose of 800
mg bid for 5 days. Other drugs such as acetylcysteine 600 mg per day and
vitamin C 500 mg bid was considered at least for 10 consecutive days. Up
to day 7th no sign of improvement in my health
condition was seen and most of the signs of the infection were worsen
during this period and insomnolence was another complication of the
COVID-19 infection. Breathing disorder including tachypnea and sporadic
cough was other complications of this infection. In this regard another
HRCT scan 5 days later from the first scan was scheduled at the
previously mentioned center and according to the results 20 %
involvement of lung was detected and the bilateral multifocal peripheral
patchy ground-glass opacity was highly suggestive for COVID-19
infection. (Fig. 1.B). At this point another consult with infectious
diseases subspecialist and a pulmonologist was taken and according to
their recommendations anti-inflammatory treatment with prednisolone 10
mg per day and colchicine 1 mg BID were considered and rivaroxaban 10 mg
per day as a preventive dose of the anticoagulant agent was taken. On
day 3rd from the anti-inflammatory treatment and day
10 from the involvement respiratory signs were improved. PO2 saturation
levels according to daily assessment from 88 % was increased to 93 or
94% although during this period fever and myalgia and headache were
suppressed but periodic fever and palpitation exist. Due to the severe
diarrhea colchicine taking was stop on the day 4th.
But my general conditioning was profoundly improved about 3 days after
initiation of anti-inflammatory therapies including prednisolone and
colchicine.