march 2020 • Annals of Internal Medicine

COVID-19 and the Risk to Health Care Workers: A Case Report

Kangqi Ng, Beng Hoong Poon, Troy Hai Kiat Puar, Jessica Li Shan Quah, Wann Jia Loh, Yu Jun Wong, Thean Yen Tan, Jagadesan Raghuram

DOI: 10.7326/L20-0175


Background: Little is known about the effectiveness of personal protective equipment for health care workers who take care of patients infected with the novel coronavirus (SARS–CoV-2) that recently originated in China and has spread globally (1, 2). Objective: To describe the clinical outcome of health care workers who took care of a patient with severe pneumonia before the diagnosis of COVID-19 was known. Case Report: The patient was a middle-aged man with diabetes mellitus and hyperlipidemia who was hospitalized in February 2020 for community-acquired pneumonia. He had not traveled recently to China nor had had contact with anyone known to have COVID-19. He required supplemental oxygen on admission; the following day, he developed respiratory distress that required endotracheal intubation by the emergency airway team and mechanical ventilation in the intensive care unit (ICU). He was transferred to the ICU for intubation and had a difficult intubation that required use of a video laryngoscope and an airway bougie. He improved clinically after 3 days of mechanical ventilation and was subsequently extubated to noninvasive ventilation.