A Mongolian patient, who had visited Korea to get a liver transplant, died on Feb. 25 at Myongji Hospital, one day after the diagnosis of the new coronavirus (COVID-19) infection. He was the first foreign patient to die from the deadly virus in Korea.

However, medical workers at Myongji said it was likely that the death resulted from underlying diseases rather than from the virus.

The 34-year-old male patient suffered from chronic liver disease and end-stage renal failure. He came to Korea for a liver transplant on Feb. 12. He received treatment at the emergency room of Seoul National University Hospital until Feb. 18. Afterward, he was staying in Namyangju, Gyeonggi Province. On Feb. 24, he suffered an esophageal hemorrhage and was taken to Myongji Hospital.

Entrance of the Myongji Hospital's emergency room where the Mongolian patient with the new coronavirus infection was admitted.

According to Myongji officials, no hospital in Namyangju was willing to receive the patient who was coughing up blood. The 119 rescue team could not help but move him to Myongji Hospital.

As the health authorities advised hospitals to take risky patients who entered the country recently to negative pressure rooms, not the emergency room, the hospital did so. With emergency medical care, the hospital ran the real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) test on him and confirmed the COVID-19 infection.

On arrival at Myongji, the patient was at a very serious status, the hospital said. The Mongolian man had end-stage renal failure and his liver function was unrecoverable. The medical team gave him a 24-hour Continuous Renal Replacement Therapy (CRRT).

The patient, who seemed to be getting better, had a sudden cardiac arrest at around 10 a.m. on Feb. 25. A doctor wearing protective clothing went into the negative pressure room and performed cardiopulmonary resuscitation (CPR) to save him. The physician also gave him a ventilator immediately, but another cardiac arrest occurred in the afternoon. The medical staff continued CPR.

The hospital called his family, including his wife and elder sister, to explain the patient’s status. His family wore protective clothing to see the patient for the last time in the negative pressure room. After seeing his family, the patient died within two hours.

Myongji Hospital said it was hard to say that COVID-19 killed him because he tested positive for the virus only after his status had already worsened with the underlying diseases.

“The patient’s illness in kidney, liver, and heart was at a serious status. It will be more rational to say the cause of his death was underlying diseases, rather than the new coronavirus,” an official at Myongji Hospital said. Instead, he missed the opportunity to get treatment because of the panic created by the COVID-19 outbreak, he added.

The health authorities said the Mongolian death case was added to the death statistics of the COVID-19 outbreak because the patient was positive in the rRT-PCR test.

However, the officials would further investigate the cause of his death, considering his symptoms, including coughing up blood.

“In the case of the Mongolian patient, we have not concluded the cause of death. As he had cirrhosis or liver disease, we will investigate whether he died from the new coronavirus or underlying diseases by going through medical records,” said Jeong Eun-kyeong, director of the Korea Centers for Disease Control and Prevention (KCDC), at a briefing on Wednesday.

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