Tension pneumothorax in a patient with Covid-19 pneumonia initially misdiagnosed as volvulus.

Tension pneumothorax is a condition that can present with a myriad of symptoms, including chest pain, shortness of breath, rapid breathing, and tachycardia. If left untreated, these signs and symptoms can progress to shock causing haemodynamic collapse and even death. At times, it may be difficult to identify tension pneumothorax. We present the case of a 59-year-old male with a prolonged initial hospital course that eventually led to a diagnosis of tension pneumothorax with the use of CT scans rather than traditional X-rays. This case reinforces the idea that clinicians should have a wide differential diagnosis in mind when dealing with vague symptoms and should not hesitate to use different diagnostic modalities to help confirm a diagnosis.

Erratum to: Acute abdomen in a 54-year-old COVID-19 patient: a case report.

[This corrects the article DOI: 10.1093/jscr/rjab198.].

A case of esophageal ulcer and hemorrhage due to aberrant subclavian in a COVID positive patient.

Coronavirus Disease 2019 (COVID-19), a global pandemic, is a respiratory infection that impairs the lungs among many other organs. We report a case of a COVID-19 positive patient requiring prolonged mechanical ventilation with nasogastric tube for enteral feeding, leading to esophageal ulcer and hemorrhage, from an aberrant right subclavian artery.

Acute abdomen in a 54-year-old COVID-19 patient: a case teport.

Although primarily a respiratory virus, coronavirus-19 acts on the gastrointestinal tract to cause symptoms such as anorexia, nausea, vomiting and diarrhea. One possible mechanism involves the ACE2 receptor, which serves as the primary receptor for virus entry into the gastrointestinal epithelium. We describe the case of a 54-year-old-male with recent coronavirus disease 2019 (COVID-19) infection, who later presented with nausea, vomiting, diarrhea and progressively worsening diffuse abdominal pain for 1 week. He was diagnosed to have a small bowel obstruction; however, continued to have progressively worsening pain and failed conservative management. No cause for the obstruction was found in the operating room. Gastrointestinal involvement occurs in at least two-thirds of patients with coronavirus infection. Viral entry into the small bowel, triggering an inflammatory response, and virus-induced microthrombosis of the microcirculation have been postulated as a possible mechanism for paralytic ileus/small bowel obstruction.

Gastric Perforation with Omental Patch Repair: A Rare Complication of Pulmonary Resuscitation in COVID-19 Pneumonia.

A 71-year-old male, diagnosed with coronavirus disease 2019 (COVID-19), was admitted to the medical-surgical floor for supportive treatment. The patient received bag-mask ventilation (BMV) secondary to severe hypoxia and reendotracheal intubation in the hospital on day eleven. A chest X-ray following reintubation noted concern for intra-abdominal air. Significant abdominal distention and subsequent diagnostic imaging showed pneumoperitoneum and a possible perforation of the stomach. The patient underwent an exploratory laparotomy with omental patching for a gastric perforation. Amidst the height of the COVID-19 pandemic, several important findings have been made through the disease sequelae of this individual patient.

Emergency Cesarean Section at 38 Weeks of Gestation with COVID-19 Pneumonia: A Case Report.

BACKGROUND Up to 47% of pregnant women with COVID-19 have preterm deliveries. A severe, symptomatic COVID-19 infection in close-to-term pregnancies can have a poor prognosis. Early identification of COVID-19 in pregnant women can prevent the progression of the disease. Currently, there is very little guidance on treating pregnant close-to-term women with COVID-19; this case report suggests changes to current management to maximize positive maternal and fetal outcomes. CASE REPORT A pregnant woman (37 weeks of gestation) presented to the Emergency Department with a chief complaint of fever with an associated cough for 2 days. She was diagnosed with COVID-19 in the Emergency Department, and discharged in a stable condition. She returned 5 days later in preterm labor with severe respiratory distress. After an emergency cesarean section, she remained intubated in the Surgical Intensive Care Unit; she was persistently hypotensive and hypoxic despite maximal ventilator and medical treatment. She died after a cardiac arrest and unsuccessful resuscitation, 15 days after the delivery. We discuss the possible benefit of a planned C-section for close-to-term pregnancies prior to the onset of COVID-19 symptoms. The patient's next of kin gave informed consent for this case report. Approval from the Institutional Review Board or Ethics Review Board was not required as this is a case report. CONCLUSIONS Currently, asymptomatic pregnant women are not tested for COVID-19 infection until hospitalization for delivery. It could be beneficial to have a protocol in place to screen asymptomatic pregnant women so they can be identified early and monitored, as COVID-19 symptoms can escalate quickly.

A Case of a Newborn Baby Girl Infected with SARS-CoV-2 Due to Transplacental Viral Transmission.

BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly infectious virus and is responsible for the current pandemic. It mainly infects cells of the lower respiratory tract and has been linked to severe respiratory complications. Although multiple routes of transmission have been reported in the literature, there is no definitive evidence for transplacental transmission. We present a case of neonatal SARS-CoV-2 likely due to transplacental transmission. CASE REPORT 31-year-old Hispanic woman in the final week of pregnancy developed mild respiratory symptoms of COVID-19 pneumonia and tested positive for SARS-CoV-2 infection. She had a history of Human immunodeficiency virus (HIV) infection and gestational diabetes. Two days later, she gave birth to a baby girl who tested positive for SARS-CoV-2 on the first day after birth. She was delivered via elective cesarean section adhering to a strict infection control protocol. CONCLUSIONS This report presents a case of a 31-year-old mother with mild symptoms of COVID-19 pneumonia who was positive for SARS-CoV-2 infection and who gave birth to a baby girl who was also positive for SARS-CoV-2. This case supports the possibility of transplacental transmission of SARS-CoV-2.

COVID-19 Precipitating Status Epilepticus in a Pediatric Patient.

BACKGROUND As the severe acute respiratory syndrome coronavirus 2 (SARS CoV2) spreads around the world infecting people of all ages, clinicians and researchers are working to gather data on the presentation of coronavirus disease (COVID-19). Further study is necessary to better diagnose and treat COVID-19 patients. CASE REPORT We describe the case of an 8-year-old boy admitted with status epilepticus, who also tested positive for COVID-19, while afebrile, with no initial respiratory symptoms. Benzodiazepines were given per treatment guidelines, abating the seizure activity. He subsequently developed respiratory distress and desaturation requiring temporary emergent intubation. All clinical symptoms resolved within a few hours. Results of a computed tomography (CT) scan of the brain were within normal limits. Results of a 24-h electroencephalogram (EEG) were abnormal, indicative of diffuse cerebral dysfunction. As a result of intubation and findings of bilateral infiltrates on chest x-ray, a COVID-19 test was administered and the result was positive. CONCLUSIONS For proper diagnosis and treatment, patients and clinicians should be aware that COVID-19 may not present in the typical fashion of respiratory distress and fever. The present case suggests a rare neurological presentation of COVID-19.