COVID-19 presenting as persistent hiccups: a case report

Sene, Diogo R; Watashi, Diego M; Bilitardo, Isabella de Oliveira; Moreno, Carlos Eduardo Campos; Moreno, Mariella Freire de Freitas

doi:10.1590/s1678-9946202163062

Cited by 4 publications

(7 citation statements)

References 13 publications

(7 reference statements)

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“…The patient was followed up by phone for 10 days and treated with chlorpromazine for the resistant hiccups, which disappeared 10 hours after starting treatment. The chlorpromazine treatment was continued for a total of 5 days, and there was no relapse after treatment discontinuation 17 …”

Section: Resultsmentioning

confidence: 99%

“…Fifteen relevant cases of COVID-19 patients presenting with persistent hiccups were found (Tables 1, 2). [6][7][8][9][10][11][12][13][14][15][16][17][18][19] All cases were men between 29 and 72 years old. Common preexisting comorbidities included hypertension (53%), diabetes mellitus (40%), and obesity (20%).…”

Section: Resultsmentioning

confidence: 99%

“…Totomoch-Serra et al 14 Sangamesh et al 15 Chiquete et al 16 Sene et al 17 Dadras e t al 18 Karampoor et al 19 A g e ,y…”

Section: Alvarez-cisneros Et Almentioning

confidence: 99%

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Characteristics and Treatments of Coronavirus Disease 2019 Patients Presenting With Persistent Hiccups: A Scoping Review

Boulis

Cosgrove

et al. 2023

Clin Neuropharm

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Objectives Over the time of the pandemic, coronavirus disease 2019 (COVID-19) has surprised us with a growing list of atypical presentations, one of which is persistent hiccups that last more than 48 hours. The aim of this review is to investigate the characteristics of COVID-19 patients presenting with persistent hiccups and explore treatments used to control persistent hiccups in such cases. Methods This scoping review was performed utilizing the methodological approach proposed by Arksey and O'Malley. Results Fifteen relevant cases were identified. All reported cases were males, aged between 29 and 72 years. More than one-third of the cases did not have symptoms of infection. All cases had a positive severe acute respiratory syndrome coronavirus reverse transcriptase–polymerase chain reaction, as well as lung involvement evident on chest imaging. The medications most frequently used for hiccups in the reported cases were chlorpromazine (6 cases, 83% success), metoclopramide (5 cases, 0% success), and baclofen (3 cases, 100% success). Conclusions In patients presenting with persistent hiccups during this pandemic, even in those lacking systemic or other manifestations of COVID-19 or pneumonia, clinicians are encouraged to consider COVID-19 as one of the differential diagnoses. In light of the findings of this review, it is recommended to include a severe acute respiratory syndrome coronavirus reverse transcriptase–polymerase chain reaction test and a chest imaging as part of the workup for these patients. When considering treatment options, this scoping review shows that chlorpromazine has more favorable outcomes compared with metoclopramide for controlling persistent hiccups in COVID-19 patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Characteristics and Treatments of Coronavirus Disease 2019 Patients Presenting With Persistent Hiccups: A Scoping Review

Boulis

Cosgrove

et al. 2023

Clin Neuropharm

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“…Pneumonia caused by common pathogens[ 8 ] as well as by SARS-CoV-2[ 3 , 4 ] has been reported as a cause of persistent hiccups. Interestingly, apart from cases of lower lobe pneumonia, which would suggest direct irritation of the diaphragm as a potential mechanism resulting in hiccups[ 8 ], the association of persistent hiccups with COVID-19 has increasing publications with other sites of lung involvement[ 9 ]. Noteworthily, our patient had only minor infiltration in the upper lobe on chest computed tomography (Figure 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…It has been used successfully for persistent hiccups of different etiologies with an action attributed to either reduction of dopamine release in the central nervous system, which could interrupt hiccup's reflex arc or induction of transient lower esophageal sphincter relaxations, by stimulating gamma-aminobutyric acid B receptors in the motor nucleus of the vagal nerve and nucleus tract solitarious[ 18 ]. Hiccups attributed to COVID-19 have been managed with hydroxychloroquine, metoclopramide, and chlorpropamide, as well as a combination scheme with baclofen included[ 3 , 4 , 9 ]. In this case, hiccups did not respond to metoclopropamide nor chlorpropamide, but on the contrary had an immediate and complete response to baclofen.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 presenting with persistent hiccup and myocardial infarction in a peritoneal dialysis patient: A case report

Bacharaki¹,

Giannakopoulos²,

Markakis³

et al. 2022

WJV

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BACKGROUND Persistent hiccups, lasting more than 48 h, have been described as an atypical presentation of coronavirus disease 19 (COVID-19) in the general population. To the best of our knowledge, this is the first report of persistent hiccups and non-ST elevation myocardial injury (NSTEMI) as an atypical presentation of COVID-19 in a peritoneal dialysis (PD) patient. CASE SUMMARY A 70-year old man, who had been on PD for 3 years with a history of ischemic heart failure and reduced ejection fraction, presented for a scheduled radionuclide myocardial scan. Upon arrival, he complained of anorexia, nausea for 5 d, and unremitting hiccups for the previous 48 h. Clinical and laboratory examinations revealed an NSTEMI plus a positive nasopharyngeal reverse transcriptase polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2. COVID-19 lung involvement was mild and was resolved without specific treatment. Myocardial injury was managed by coronary catheterization and stenting, while hiccups responded only to baclofen per os . CONCLUSION Persistent hiccups and NSTEMI can be atypical presentations of COVID-19 in peritoneal dialysis patients, which may be due to involvement of the central nervous system and myocardial injuries.

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Persistent Hiccups as an Atypical Presentation of SARS-CoV-2 Infection: A Systematic Review of Case Reports

et al. 2022

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Symptoms, such as fever, dry cough, dyspnoea, and respiratory distress, are commonly described in patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Recently, a growing number of cases pertained to persistent hiccups have been reported by SARS-CoV-2 infected patients. The aim of this systematic review was to screen the current literature and provide a summary of the reported cases of SARS-CoV-2 infected patients presenting with persistent hiccups. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, Scopus, and Web of Science databases were searched from inception until October 2021. Case reports or case series that provided a separate clinical description for patients with presenting complaints of persistent hiccups before or after COVID-19 diagnosis were retrieved. The critical appraisal checklist for case reports provided by the Joanna Briggs Institute (JBI) was employed to evaluate the overall quality of the eligible studies. We identified 13 eligible studies that included 16 hospitalized COVID-19 patients who complained of persistent hiccups. The mean duration of hiccups was 4.6 days reported in 88% (14/16) patients. Hypertension was the most common comorbidity present in 50% (8/16) of patients followed by diabetes mellitus (4/16). Moreover, 44% (7/16) of patients received only one medication for managing the hiccups with metoclopramide (5/16) followed by chlorpromazine and baclofen (4/16) used as primary treatment. Equally, 44% of patients (7/16) received dexamethasone followed by azithromycin (5/16), ivermectin (4/16), and ceftriaxone (4/16) for managing the infection from SARS-CoV-2. The majority of patients (14/16) improved after initiation of treatment. Persistent hiccups are possibly a rare symptom that clinicians may expect to encounter in patients infected with SARS-CoV-2. Although there is not ample proof to propose causation, increased awareness about the diversity of presentations of SARS-CoV-2 infection could be crucial in the early recognition of the disease.

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COVID-19 presenting as persistent hiccups: a case report

Cited by 4 publications

References 13 publications

Characteristics and Treatments of Coronavirus Disease 2019 Patients Presenting With Persistent Hiccups: A Scoping Review

Characteristics and Treatments of Coronavirus Disease 2019 Patients Presenting With Persistent Hiccups: A Scoping Review

COVID-19 presenting with persistent hiccup and myocardial infarction in a peritoneal dialysis patient: A case report

Persistent Hiccups as an Atypical Presentation of SARS-CoV-2 Infection: A Systematic Review of Case Reports

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