A gentleman in his early fifties became ill with flu-like symptoms after vacationing abroad and was diagnosed with COVID-19 after returning to Iceland. A few days later he was admitted to the University Hospital, Landspitali, due to worsening respiratory symptoms and severe fatigue. A computed tomography scan of lthe lungs showed diffuse bilateral consolidations and ground glass changes. He developed respiratory failure and was transferred to the intensive care unit where he received further treatment, including tocilizumab (IL-6 receptor inhibitor). He subsequently showed clinical improvement and did not require endotracheal intubation.

Variable	Results	Reference Range	Unit
White-cell count	12.6	4-10,5	x109/L
Hemoglobin	138	134-171	g/L
Neutrophils	10.9	1,9-7	x109/L
Lymphocytes	1	1-4	x109/L
Monocytes	0.5	0.3-0.9	x109/L
Eosinophils	0	<0.5	x109/L
Basophils	0	<0.2	x109/L
APTT	53.5	29-44	sec
PT	16.5	12.5-15	sec
INR	1,1	0.8-1.1
Fibrinogen	7.3	1.5-4	g/L
Sodium	132	137-145	mmol/L
Potassium	2.8	3.5-4.8	mmol/L
Creatinine	81	60-100	mmol/L
GFR	>90	>60	ml/min/1.73m2
Ferritin	2180	30-400	µg/L
CRP	220	<10	mg/L
ALP	55	35-105	U/L
ASAT	24	<45	U/L
ALAT	19	<70	U/L
Procalcitonin	0.16	<0.05	µg/L

Table I. Results from blood tests during the first day of admission. D-dimer measured later was 6,14 (reference range 0,5 mg/L).

Table II. Results from immunology tests taken during admission to the intensive care unit. Other measured cytokines, IL-2, IL-4, IL-5, IL-10, IL-12, IL-12p70, IL-13, IL-15, IL17A, IL-17E, GM-CSF and IFN-ɣ, were all under the standard curve. * Value under the standard curve

Immunology Tests		Results (pg/ml)	Reference Range (pg/ml)
IL-6		22.04	<3,66
CD40L		5861	<4336
MIP-3a		25	<4
IL-1b		0.74*	<0,34
TNFa		6.75*	<5.95

Early Symptoms	%
Fever	991
Fatigue	701
Dry cough	591
Anorexia	401
Muscle pain	351
Dyspnea	311
Olfactory/gustatory changes	342

Table III.

Blood Results Associated With Worse Outcomes 11

↓ Lymphocytes

↑ LDH

↑↑ CRP

↑↑ Ferritin

↑ PT

↑ Troponin

Liver injury

Kidney injury

Table IV.