COVID-19: The Case of Three Patients with the Same Diagnosis but Different Clinical and Laboratory Features

Abstract

SARS-CoV-2 is an RNA virus that causes COVID-19, which has been responsible for the pandemic that was declared in early 2020. Its pathological effect is majorly in the respiratory tract, but its full pathogenicity remains a mystery. Symptoms associated with COVID-19 include fever, cough, and shortness of breath. Some patients develop other symptoms like diarrhea. However, it is possible for other organs to be affected including the central nervous system, liver, and blood cells. The purpose of this case series is to unravel other factors associated with this disease, so we report three cases of COVID-19 that were hospitalized during the pandemic.

Epileptic seizures in patients with COVID-19: A systematic review of early evidences

“…The trans-synaptic viral transfer is reported for other CoVs clathrin-dependent endocytotic/exocytotic pathway. Although SARS-CoV-2 enters through BBB in Nervous system, interestingly except one case study [11] all tested SARS-CoV-2 PCR in CSF was negative in our review [5,10,[12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Diminished viral RNA in the brain in autopsy studies (7 out of 22) of SARS-CoV-2 related fatality is suggestive of it [47].…”

“…Among these articles, 12 were case reports; four were case series, and one study was a multicentre crosssectional study. Table-1 and Table-2 shows the summary of the included studies [5,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. All studies were critically analyzed based on the standard diagnosis for epilepsy (e.g., EEG, head CT /MRI, CSF analysis).…”

“…Stephano et al reported focal injury in absence of encephalopathy and cerebral microbleeds -a result of cytokine release [16], whereas others reported cytokine storm [21] with encephalopathy [18]. Past researchers connected status epilepticus (SE) induced glutamate release and excessive stimulation of glutaminergic receptors and N-methyl-D-aspartate receptors (NMDARS) [37,38], linked with seizure and neurological morbidity in SARS-CoV-2 outbreak [12,13,20]. Electrolyte imbalance was the less likely cause of new onset of seizures, observed in two of the reports, but a clear indication towards encephalitis and normocapnic hypoxia as a cause [12,15].…”

“…Past researchers connected status epilepticus (SE) induced glutamate release and excessive stimulation of glutaminergic receptors and N-methyl-D-aspartate receptors (NMDARS) [37,38], linked with seizure and neurological morbidity in SARS-CoV-2 outbreak [12,13,20]. Electrolyte imbalance was the less likely cause of new onset of seizures, observed in two of the reports, but a clear indication towards encephalitis and normocapnic hypoxia as a cause [12,15]. Dixon et al reported acute necrotizing encephalopathy with rapid progression of seizures and reduced consciousness [17].…”

Descriptive Analysis of Factors Associated with COVID-19 (U07.1, U07.2), Viral Pneumonia (J12.8 and J12.9) and other Types of Admission Diagnosis

“…percent, rhinorrhoea was at 4 percent, chest pain was at 2 percent, diarrhoea was at 2 percent, and nausea and vomiting was at 1 percent.A study by Atere, et al showed that a dry cough, chest pain and dyspnoea were prominent in patients with lower respiratory tract symptoms on admission[3]. Other types of diagnosis for admission in a study by Willie and Motsepe included unspecified acute lower respiratory infection, other viral pneumonia, Adult respiratory distress syndrome, Bronchopneumonia, unspecified -Gastroenteritis, and colitis of unspecified origin[1].…”