The novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) is the cause of the COVID-19 pandemic [
5
]. SARS-Cov-2 demonstrates partial resemblance to SARS-CoV and MERS-CoV in phylogenetic analysis, clinical manifestations, and pathological findings [
6
, 7]. Reports emerging from China have described ataxia as a neurological symptom of the SARS-CoV-2 infection [
5
]. Opsoclonus consists of back-to-back multidirectional conjugate saccades without an inter-saccadic interval [
8
]. Myoclonus is defined as a sudden, brief, “shock-like”, nonepileptic involuntary movement [
9
], which has been described as a symptom of SARS-CoV-2 infection [
10
]. Opsoclonus-Myoclonus-Ataxia syndrome (OMAS) associated COVID-19 infection has been reported recently [
11
12
].
A 40-year-old male who prefers to speak Spanish presents to the emergency room with 12 days of fever, myalgias, generalized weakness, progressive shortness of breath, and nonproductive cough. His medical history is notable for obesity, uncontrolled type 2 diabetes, and hypertension, and he currently takes no medications. His oxygen saturation on room air is 82% with a respiratory rate of 34/min. He is placed on 5 Liters nasal cannula and subsequently escalated to heated-high flow nasal cannula. He is diagnosed with acute hypoxemic respiratory failure due to COVID-19 pneumonia. He has not received the COVID vaccine, citing limited transportation and his work schedule as significant barriers. Numerous sick contacts include his wife and two teenage daughters, who are all unvaccinated, and his coworkers, with whom he carpools to job sites. Phone interpretation has been the only communication option throughout the hospitalization. Pending discharge, physical therapy recommends post-acute rehabilitation but when case management inquires about his need for rehabilitation the patient discloses that he is ineligible for insurance due to his immigration status.His last primary care visit at the free clinic was more than 1 year ago.
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