eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2022-04-23 10 4 101 109 10.12691/ajmcr-10-4-5 AJMCR20221045 article Chenglu Zhang 1 Haohao Cao 2 Donghui Huang 2 Hongfeng Jiang jhf2@sina.com 3 Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Department of Critical Medicine, Wuhan Fourth Hospital & Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Geriatrics Department, Wuhan Fourth Hospital & Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Introduction: Corona Virus Disease 2019 (COVID-19) has spread rapidly throughout the world. Many people died of this disease. We reported a case of critical illness with COVID-19 pneumonia that occurred in the early stage of viral spread in China and describe the identification, diagnosis, clinical course, and management of the case, including the patient¡¯s symptoms throughout the course. Patient concerns: This article describes the whole diagnosis and treatment process of a critically ill patient in a case report. Diagnosis: The patient was a physician and presented to a fever clinic with a history of treating a suspected patient without special protection the day before. After 5 days, a nucleic acid test for COVID-19 was positive. Then, the patient was transferred to the intensive care unit (ICU) immediately because of severe dyspnea. He was diagnosed with COVID-19 based on a history of exposure, severe acute respiratory syndrome, positive COVID-19 test and chest computed tomography (CT). Interventions: Various therapies were used in this critically ill patient, including anti-infection drugs, hormones, immunoglobulins, herbal medicine, noninvasive ventilation, and special plasma. Outcomes: The patient recovered completely and was discharged after one month of hospitalization. COVID-19 was tested negative and a chest CT showed marked improvement prior to discharge after 4 weeks admission. Conclusion: This study highlights the complexity of treatment and recurrent positivity of the critically ill COVID-19 pneumonia patient and aims to provide useful reference and information for our knowledge of the clinical spectrum of disease. http://pubs.sciepub.com/ajmcr/10/4/5/ajmcr-10-4-5.pdf COVID-19 coronavirus pneumonia diagnosis treatment