Extrapulmonary and atypical clinical presentations of COVID‐19

Abobaker, Anis; Raba, Ali Ahmed; Alzwi, Aboubaker

doi:10.1002/jmv.26157

Cited by 102 publications

(117 citation statements)

References 53 publications

(137 reference statements)

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“…While COVID-19 mainly causes lung injury and severe hypoxic respiratory failure, many studies have reported extrapulmonary manifestations as well. Some of the recent data have suggested neurological, cardiac, gastrointestinal, ocular, renal, and cutaneous manifestations of COVID-19 [ 1 , 2 , 4 ]. However, there is no indication in the current data showing a link between SARS-CoV-2 and hypoparathyroidism.…”

Section: Discussionmentioning

confidence: 99%

A Novel Case of Hypoparathyroidism Secondary to SARS-CoV-2 Infection

Elkattawy

Alyacoub

Ayad

et al. 2020

Cureus

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Hypoparathyroidism is usually caused by postsurgical or autoimmune damage to the parathyroid gland. We present the case of a 46-year-old Hispanic male with no significant past medical history who was admitted to the hospital with hypoxic respiratory failure due to coronavirus disease 2019 (COVID-19) infection and had a prolonged hospital course. He was incidentally found to have hyperphosphatemia and low parathyroid hormone (PTH) levels. During the second month of hospitalization, his phosphorus levels rose to 6.9 mg/dL (normal range: 2.4-4.7 mg/dl). His PTH levels were found to be at 8 pg/mL. Vitamin D levels obtained were also low (7 ng/dL), phosphorus was at 5.8 mg/dL with albumin of 2.9 g/dL, and calcium level was normal at 9.2 mg/dl. Parathyroid hormone-related peptide (PTHrP) level was low at 10. Malignancy and genetic causes were ruled out. The patient was started on 50,000 units of ergocalciferol once a week. He was also started on calcium acetate 1,334 mg three times a day for hyperphosphatemia. Phosphorus levels remained elevated, and sevelamer was added on discharge after he was weaned off oxygen and cleared by physical therapy. No explanation for persistent hyperphosphatemia and hypoparathyroidism was found. To date, there have been some reports linking severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to widespread tissue injury; however, there have been no reports so far on the effect of the parathyroid gland. Further studies are necessary to elaborate and to confirm the causative relationship between SARS-CoV-2 and hyperphosphatemia.

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Section: Discussionmentioning

confidence: 99%

A Novel Case of Hypoparathyroidism Secondary to SARS-CoV-2 Infection

Elkattawy

Alyacoub

Ayad

et al. 2020

Cureus

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“…Although COVID-19 is mainly a respiratory disease characterised by pulmonary manifestations, reports on extrapulmonary manifestations are not uncommon in the published literature. Some of these include gastrointestinal, cardiac, neurological and cutaneous manifestations, features of renal and liver dysfunction, as well as taste and smell disorders [33,34]. Patients with gastrointestinal involvement may present with symptoms such as diarrhoea, vomiting, abdominal pain and loss of appetite [35] whereas neurological manifestations such as encephalitis, encephalopathy, stroke and Guillain Barre Syndrome have been reported [9].…”

Section: Clinical Characteristics In Generalmentioning

confidence: 99%

The SARS-CoV-2 Outbreak: an Epidemiological and Clinical Perspective

Wong

2020

SN Compr. Clin. Med.

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak started with the detection of an increasing number of pneumonia cases of unknown origin in Wuhan, China, since December 2019. The disease caused by SAS-CoV-2 was subsequently named coronavirus disease 2019 (COVID-19). Currently, the ongoing COVID-19 pandemic poses a global health concern with more than 28.9 million confirmed cases, taking away the lives of more than 900,000 people worldwide. To prevent further spread of the disease, an understanding of the clinical characteristics and how the disease spread is essential, especially for an emerging disease like COVID-19. Individuals who are infected with SARS-CoV-2 show diverse clinical features, and the disease severity can range from asymptomatic to death. The disease has been shown to affect not just the respiratory system but also other systems of the body. This review will discuss the pulmonary and extra-pulmonary clinical manifestations of COVID-19 in general, as well as the clinical characteristics in different groups of patients such as children, the elderly, pregnant women, patients with comorbidities and those with a compromised immunity. It will also critically examine existing evidence from relevant studies and discuss the SARS-CoV-2 outbreak from an epidemiological perspective. With the easing of control measures in many countries after months of lockdown, it is important to revisit the lessons learnt from research, as the world enters a new normal with the coexistence of SARS-CoV-2.

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“…Fever, cough, shortness of breath, anosmia, ageusia, or dysgeusia are the most common symptoms of COVID-19. However, a wide variety of atypical presentations have also been described [ 1 ]. Some uncommon presentations are related to the hypercoagulable state, while others are a result of the inflammatory response.…”

Section: Introductionmentioning

confidence: 99%

Hiccups and psychosis: two atypical presentations of COVID-19

2021

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The WHO defines a possible case of COVID-19 as a person experiencing fever, cough, shortness of breath, and neurological signs including anosmia, ageusia, or dysgeusia. However, experiences from hospitals all over the world have shown that presentations vary widely. Some atypical presentations include cardiac, gastrointestinal, neurological, and cutaneous and while some are driven by the inflammatory response, others are a consequence of the hypercoagulable state. In our emergency department in a private hospital in Mexico City, we received two patients with very different symptoms on the same shift. Two previously healthy men in their 40s presented to the ER with very atypical manifestations of COVID-19. Neither of them complained of fever, cough, or shortness of breath. The first referred a 3-day history of hiccups that had not resolved with metoclopramide. The second presented with an acute episode of altered mental status. While the first case revealed lung involvement of the disease, the second case had a clean chest CT scan. These cases are relevant as manifestations of COVID-19 vary widely, especially in previously healthy young adults.

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Extrapulmonary and atypical clinical presentations of COVID‐19

Cited by 102 publications

References 53 publications

A Novel Case of Hypoparathyroidism Secondary to SARS-CoV-2 Infection

A Novel Case of Hypoparathyroidism Secondary to SARS-CoV-2 Infection

The SARS-CoV-2 Outbreak: an Epidemiological and Clinical Perspective

Hiccups and psychosis: two atypical presentations of COVID-19

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