Prolonged Confusional state as first manifestation of COVID-19

ABSTRACT

Abstract A 77 year old gentleman, normally fit and well, was admitted with acute confusion. On admission GCS was 14/15, vital signs were within the normal limits and bilateral crepitation at the lung base. Head CT scan normal. CXR showed some air space opacification. Investigations revealed hyponatraemia, raised CRP and positive for COVID-19. Treated with antibiotics and intravenous saline, sodium returned to normal. Delirium remained unchanged four weeks post incidence. Neurological manifestations were documented in patients with COVID-19, however no report has shown delirium as a primary manifestation. This case illustrates acute confusion may be the only presenting symptom of COVID-19 without overt lung disease.