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

Guntur Darmawan, Samadhi Tulus Makmud

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. 


Keywords


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

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.


Full Text: PDF

Refbacks

  • There are currently no refbacks.