The ‘Great Imitator’: A Case of COVID-19 Presenting with Encephalitis and Acute Coronary Syndrome

Authors

  • Guntur Darmawan 1. Department of Internal Medicine, Faculty of Medicine, Krida Wacana Christian University, Jakarta, Indonesia 2. Department of Internal Medicine, Sumber Waras General Hospital, Jakarta, Indonesia 3. Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
  • Samadhi Tulus Makmud Department of Neurology, Sumber Waras General Hospital, Jakarta, Indonesia

Keywords:

COVID-19, extra-pulmonary manifestation, acute myocardial infarct, seizure, loss of consciousness

Abstract

Although typically patients with coronavirus disease-19 (COVID-19) have pulmonary symptoms atypical cases can occasionally present with extra-pulmonary symptoms. We report an interesting case of COVID-19 female patient presenting with combination of central nervous system disorder and acute myocardial infarct as initial manifestation. Multiorgan involvement in COVID-19 might lead to multiple atypical presentation which could be overlooked by the physician. 

References

Del Rio C, Malani PN. COVID-19—new insights on a rapidly changing epidemic. JAMA. 2020;323(14):1339-40.

Fischer Q, Darmon A, Ducrocq G, Feldman L. Case report of anterior ST-elevation myocardial infarction in a patient with coronavirus disease-2019. Eur Heart J Case Reports. 2020;4:1-5.

Sohal S, Mossammat MJ. COVID-19 Presenting with Seizures. IDcases. 2020(20):e00782.

Asadi-Pooya AA, Simani L. Central nervous system manifestations of COVID-19: A systematic review. J Neurol Sci. 2020(413):116832.

Lai C-C, Ko W-C, Lee P-I, Jean S-S, Hsueh P-R. Extra-respiratory manifestations of COVID-19. Int J Antimicrob Agents. 2020;56(2):106024.

Bansal M. Reviews: Cardiovascular disease and COVID-19. Diabetes Metab Syndr. 2020;14:247-50.

Bangalore S, Sharma A, Slotwiner A, et al. ST-segment elevation in patients with Covid-19—a case series. NEJM. 2020;382:2478-80.

Anand P, Al-Faraj A, Sader E, et al. Seizure as the presenting symptom of COVID-19: a retrospective case series. 2020;112:107335.

Moriguchi T, Harii N, Goto J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. 2020;94:55-8.

Gupta A, Madhavan MV, Sehgal K, et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26(7):1017-32.

Zheng KI, Feng G, Liu W-Y, Targher G, Byrne CD, Zheng M-H. Extrapulmonary complications of COVID-19: A multisystem disease? J Med Virol. 2020:1-13.

Kong M, Zhang H, Cao X, Mao X, Lu Z. Higher level of neutrophil-to-lymphocyte is associated with severe COVID-19. Epidemiol Infect. 2020;148:e139.

Lippi G, South AM, Henry BM. Electrolyte imbalances in patients with severe coronavirus disease 2019 (COVID-19). Ann Clin Biochem. 2020;57(3):262-5.

Lippi G, Wong J, Henry BM. Hypertension and its severity or mortality in Coronavirus Disease 2019 (COVID-19): A pooled analysis. Arch Intern Med. 2020;130(4):304-9.

Singh AK, Gupta R, Misra A. Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers. Diabetes Metab Syndr. 2020;14(4):283-7.

Fosbøl EL, Butt JH, Østergaard L, et al. Association of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use with COVID-19 diagnosis and mortality. JAMA. 2020;324(2):168-77.

Kreutz R, Algharably EAE-H, Azizi M, et al. Hypertension, the renin–angiotensin system, and the risk of lower respiratory tract infections and lung injury: implications for COVID-19: European Society of Hypertension COVID-19 Task Force Review of Evidence. Cardiovasc Res. 2020;116(10):1688-99.

Peeling RW, Wedderburn CJ, Garcia PJ, et al. Serology testing in the COVID-19 pandemic response. Lancet Infect Dis. 2020;20(9):e245-e9.

Downloads

Published

2021-03-31

How to Cite

Darmawan, G., & Makmud, S. T. (2021). The ‘Great Imitator’: A Case of COVID-19 Presenting with Encephalitis and Acute Coronary Syndrome. Acta Medica Indonesiana, 53(1), 82. Retrieved from http://actamedindones.org/index.php/ijim/article/view/1590