Dizziness can be an early sole clinical manifestation for COVID-19 infection: A case report.

ABSTRACT

SARS-CoV-2 is a novel strain of coronavirus that was first identified in Wuhan, China; it has since spread rapidly throughout the world. Most of the patients with COVID-19 present with respiratory symptoms, including cough, nasal symptoms, fever, and shortness of breath. However, several groups have reported that SARS-CoV-2 can infect the central nervous system via the olfactory bulb followed by spread throughout the brain and peripheral nervous system. This brief report illustrated a 78-year-old man who presented to the emergency department (ED) on March 22, 2020, with chief complaints of dizziness and unsteadiness while walking. He had no symptoms suggestive of COVID-19 on arrival. SARS-CoV-2 nasopharyngeal swab test performed at that time due to his atypical presentation and lymphocytopenia was positive for virus nucleic acids. The neurological symptoms associated with COVID-19 are frequently non-specific and may emerge several days before the respiratory symptoms; as such, identification of patients presenting with these subtle and seemingly unremarkable COVID-19 symptoms will be quite difficult. Added to this, numerous countries still limit testing for SARS-COV-2 to patients presenting with fever or respiratory symptoms. Frontline physicians should be aware of early, non-specific symptoms associated with SARS-CoV-2 infection.