MULTIPLE RIB FRACTURES, PLEURAL EFFUSION AND RIGHT-SIDED DIAPHRAGMATIC HERNIATION OF THE COLON INTO THE CHEST ASSOCIATED WITH CHRONIC COUGH AFTER COVID-19.

Rib fractures are an infrequent consequence of severe cough. In some patients, undetected rib fractures can lead to life-threatening outcomes. The case of a 73-year-old man who presented with shortness of breath and a worsening dry cough from a SARS-CoV-2 infection for 4 weeks is described. In the emergency department, he was found to be hypoxic and hypotensive. Imaging studies revealed a large right pleural effusion, multiple rib fractures, and right-sided herniation of the colon into the chest. He was admitted to the cardiothoracic intensive care unit where he underwent a flexible bronchoscopy, right video-assisted thoracoscopic surgery, evacuation of a haemothorax, complete decortication, and repair of a diaphragmatic hernia. This case is an unusual presentation of an amalgamation of rare complications resulting from an unrelenting, poorly controlled SARS-CoV-2 infection cough that prompted rapid recognition and swift action. LEARNING POINTS: Physical examination and plain radiography frequently miss costal arch fractures if no bone pathology or history of trauma is present.Controlling cough is important, and decreases the chances of complications and rupture of organs.New-onset chest pain with a background of chronic cough makes cough-induced rib fracture a probable differential diagnosis. Pleural effusion in a patient presenting with cough and a rib fracture should make clinicians suspect haemothorax.

Echocardiography, lung ultrasound, and cardiac magnetic resonance findings in COVID-19: A systematic review.

BACKGROUND: The manifestations of COVID-19 as outlined by imaging modalities such as echocardiography, lung ultrasound (LUS), and cardiac magnetic resonance (CMR) imaging are not fully described. METHODS: We conducted a systematic review of the current literature and included studies that described cardiovascular manifestations of COVID-19 using echocardiography, CMR, and pulmonary manifestations using LUS. We queried PubMed, EMBASE, and Web of Science for relevant articles. Original studies and case series were included. RESULTS: This review describes the most common abnormalities encountered on echocardiography, LUS, and CMR in patients infected with COVID-19.