ABSTRACT
We report a rare case of a patient presenting with a very unusual manifestation of coronavirus disease 2019 (COVID-19). A 62-year-old male presented to the emergency department (ED) with complaints of headache, nausea, vomiting, and intractable hiccups for two days. Laboratory results showed that he had profound hyponatremia (Na+: 103 mEq/L) and hypokalemia (K+: 2.3 mEq/L) with a positive RT-PCR for COVID-19. He was treated with an intravenous (IV) bolus of 3% saline solution followed by continuous infusion. The patient was discharged after eight days when his electrolytes returned to normal, and a significant symptomatic relief was achieved.
ABSTRACT
Background: coronavirus disease (COVID-19) as an emerging infectious disease started in China in 2019. By increasing the number of patients and spreading to all countries, it was considered a pandemic disease. COVID-19 became an international concern. Patients affected by coronavirus (SARS-Cov-2) reported different symptoms. Most signs and symptoms were related to the respiratory system. To our knowledge, the onset of Covid-19 with chronic hiccups was reported in two patients. The aim of this study was to assess the onset of symptoms of Covid-19 disease in patients in a hospital in Zabol, Iran. Methods: This study is a retrospective descriptive cross-sectional study which was performed from March to June 2021. The study setting was a hospital affiliated with Zabol Medical University. The study population included all patients diagnosed with Covid-19. A total of 350 patients were selected by the census. For data gathering, we used Patient’s records including demographic information, clinical examination records, and para-clinical tests results. We used descriptive statistics and SPSS ver. 20 for data analysis and management. Results: A total of 350 patients were diagnosed with Covid-19. The number of 232 (66.28%) patients were hospitalized for receiving hospital care. 118(33.72%) were recommended to stay at home and receive care. Inpatients included 119(51.29%) male and 113(48.71%) female. The mean age of patients was 41.75(±15.6) years. The main complaint of 349(99.71%) patients was respiratory problems. A 44-year-old male patient with a history of 8 years of diabetes had chronic hiccups. Conclusion: according to our findings, unexpected signs and symptoms should be considered during the pandemic event. By identifying different symptoms of the disease, the provision of health services from diagnosis to care and treatment is improved. Since Covid-19 disease is an emerging disease and all its dimensions have not been identified yet, a thorough examination of patients who are referred to medical centers can help identify and reporting different cases. [ FROM AUTHOR] Copyright of Tehran University Medical Journal is the property of Tehran University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
The possibilities of coronavirus disease 2019 (COVID-19) to present with atypical manifestations have reported. Information of COVID-19 atypical signs and symptoms is still emerging globally. One of these presentations is persistent hiccups. One of the hypotheses is that COVID-19 has been linked to several neurological manifestations and effects. Some observations noticed phrenic nerve paralysis after COVID-19 infection leading to pulmonary failure. We report one case of COVID-19-positive patient where he presented with persistent hiccups. Many predisposing factors might lead to the development of hiccups in COVID-19 infection such as a history of smoking, phrenic and vagus nerve damage or irritation, high inflammatory markers, lower lobe pneumonia, ground-glass-like appearance on x-rays. We hypothesize that hiccups are the first sign of serious deterioration of patients with COVID-19 and such patients are at high risk of developing kidney injury and intubation.
ABSTRACT
BACKGROUND: Hiccups are involuntary diaphragmatic muscle contractions with early glottis closure terminating inspiration. They are classified into two types: acute (<48 hours) and persistent (>48 hours). COVID-19 is the defining health crisis of our generation. Although there are common symptoms of the disease (e.g. fever, cough), several atypical presentations have appeared as the pandemic has evolved. Here, we present a patient with COVID-19 presenting with fever, sore throat, and persistent hiccups. METHODS AND RESULTS: A 48-year-old man presented to the hospital with a seven-day history of persistent hiccups, fever, and sore throat. Physical examination was unremarkable and abdominal ultrasound showed gaseous abdominal distension. Laboratory values were remarkable for elevated C-reactive protein, ferritin, and lactate dehydrogenase levels. Computed tomography of the chest showed bilateral subpleural areas of ground-glass attenuation and crazy-paving pattern. A COVID-19 test was positive, and hydroxychloroquine, oseltamivir, baclofen, and symptomatic treatment were initiated. The hiccups improved, and the patient was discharged home after ten days. CONCLUSION: Physicians should maintain a high level of suspicion and be aware of atypical presentations of COVID-19.