2 CASE HISTORY AND EXAMINATION
On April 13 at 11:30 AM, 2020, 30-year-old man came to a tertiary hospital, Dhaka, Bangladesh with significant signs and symptoms of COVID 19 and he had dry cough, muscle pain, fever, headache and shortness of breath. On the spot, he admitted and recorded the vital signs of COVID 19. The vital signs are shown in table 1. He had no history of direct contact of COVID 19 positive patients. On 14th April at 10:15 PM, he was confirmed COVID 19 using RT-PCR nasal swab test. The result of RNA detection of SARS CoV-2 was positive (Table 2). Same at 00:45 AM, h was moved to an isolated cabin and received supportive treatment.The next day on 15th April at 9:45 PM, he had got complete blood counts and results did not reveal leukocytopenia. Chest X-ray, on the other hand , showed ground-glass darkness in the center and lower right of the lung (Table 2). The chest X-ray examination revealed that he was strongly suspected of having COVID-19. On 16 April at 10:30 a.m., he was inspired to re-test two samples (nasal and throat) for RT-PCR and the findings were positive. Same at 11:35 PM, he was treated with antibiotics (azithromycin500), O2 inhilation, intravenous fluid, paracetamol500, Montelukast10, and Fexofenadine120. After 3 days of treatment (19th April, 2020), his fever and breathing difficulty improved and his condition was stable for 72 hours. On 23rd and 24th April, he was tested for SARS CoV-2 RNA with two subsequent throat swab samples respectively. The results of RT-PCR were negative (Table 2). On 25thApril at 11:25 AM, he was discharged and recommemded to follow the rule-and-regulations of home quarantine for the next 14 days. On 1st May 2020, during his follow-up period, he was recommended to monitor the blood IgM and IgG against SARS CoV-2 antigen. Antibodies (IgM and IgG) were measured using point-of-care test and results showed the protective level of IgG (Table 2). The shapshot of COVID-19 is shown in figure 1.