[Coronavirus (SARS-CoV-2) - Outbreak in North Rhine-Westphalia (District of Heinsberg) - First diagnosis of a COVID-19 manifestation in a couple].

Laufs, Jendrik; Elsbernd, Harry; Hölzl, Friedrich; Winter, Klaus-Dieter

HISTORY AND CLINICAL FINDINGS Up to February 24th 2020 occasionally occuring SARS-CoV-2 infections in Germany without severe course. Emergency presentation of a couple in the emergency room. For seven days now, the man has fever, dry cough und physical weakness and the wife has similar symptoms of a milder form. The clinical examination shows fine crackles over both lungs and a respiratory failure of the husband. INVESTIGATIONS AND DIAGNOSIS Laboratory increase in inflammation parameters as well as transaminases and lactate dehydrogenase. Radiologically lung infiltrates of different severity. Further on diagnosis of a SARS-CoV-2-infection of both patients with a severe course of the male. TREATMENT AND COURSE Intubation and mechanical ventilation of the male patient with prolonged intenive care treatment. Recovery of the female patient under conventional oxygen therapy. DISCUSSION These two cases show the starting point of an endemic spread of SARS-CoV-2 in the district of Heinsberg (North Rhine-Westphalia) and up to this point the first case of a life-threatenning course in Germany.