• Kyohei Miyamoto, Takafumi Yonemitsu, Rikako Tanaka, Tsuyoshi Nakashima, Mami Shibata, Ryosuke Funahashi, Keiko Yamasaki, Mario Yamada, Kaori Tamoto, Keiichiro Akamatsu, Machiko Nishio, Hiroki Yamaue, and Seiya Kato.
• Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan.
• Acute Med Surg. 2020 Jan 1; 7 (1): e521.

BackgroundCoronavirus disease (COVID-19) is a growing concern worldwide. Approximately 5% of COVID-19 cases require intensive care. However, the optimal treatment for respiratory failure in COVID-19 patients is yet to be determined.Case PresentationA 79-year-old man with severe acute respiratory distress syndrome due to COVID-19 was admitted to our intensive care unit. Prone ventilation was effective in treating the patient's hypoxemia. Furthermore, the patient received lung protective ventilation with a tidal volume of 6-8 mg/kg (predicted body weight). However, the patient's respiratory failure did not improve and he died 16 days after admission because of multiple organ failure. Serial chest computed tomography revealed a change from ground-glass opacity to consolidation pattern in both lungs.ConclusionsWe report a protracted case of COVID-19 in a critically ill patient in Japan. Although prone ventilation could contribute to treating hypoxemia, its efficacy in preventing mortality from COVID-19 is unknown.© 2020 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.

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