“COVID-19-the great imitator”- a case report

Nevena Ivanova

Keywords: COVID-19, GP, diversity simptoms

Introduction:

: COVID‐19 (SARS‐CoV‐2 virus) is a novel coronavirus which emerged in Wuhan, China in December 2019 and became pandemic in March 2020. Symptoms of infection are nonspecific and their severity can vary. COVID‐19 mainly affects the respiratory tract from mild symptoms to bilateral pneumonia and acute respiratory distress syndrome. Due to a global inflammatory response and endothelial damage, COVID‐19 may predispose to cardiovascular disorders. Some symptoms are due to nervous system involvement-headache, loss of taste and smell, muscle and joint pain, “brain fog”, anxiety, posttraumatic stress disorder, depression and insomnia. GPs are first line doctors, so it is of great importance to diagnose including complications and make a proper decision about the treatment

Case:

45 years old women has been diagnosed for COVID-19 with PCR test. She was under home treatment prescribed and followed by her GP by phone. She suffered fever, severe dry cough, tiredness loss of smell and appetite After a week complained extreme muscle, joint, abdominal and back pain, diarrhea, severe headache with no possible relief and hallucinations. She developed anxiety, insomnia and depressive thoughts after hair loss. On a 20th day reported chest pain, heaviness, daggers, palpitations and arrhythmias. Those were interpreted by GP as panic attacks, and treated with sedatives. Accompanying diseases-breast cancer with partial mastectomy, chemo and hormonal therapy 15 years ago, menopause. Neither lab test, ECG, X-ray or CT scan were recommended by GP. After a month she visited cardiologist who diagnosed pericarditis, episodes of atrial fibrillation and initiated treatment.

Discussion:

COVID-19 is a novel disease, without previous experience and data available. The mechanisms of damages are still unclear, so as treatment. That is a challenge for GPs to cope with diversity of symptoms and make proper diagnose of complications, especially in a distance and lack of financial recurces

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