Unusual Extra Pulmonary Clinical Manifestation as Initial Presenting Feature of COVID-19 and its Management: A Systematic Review of Case Reports
Abstract
Corona virus disease 2019 (COVID-19) is primarily an infectious disease of the respiratory system. COVID-19 might have unusual extra pulmonary clinical manifestations as initial symptoms. This systematic review included case reports published from January 2020 to June 2022 in English language that met the following criteria: unusual clinical manifestations as a sole or first initial manifestation of COVID-19, Confirmed positive Reverse Transcription Polymerase Chain Reaction (RTPCR) and real time RTPCR COVID-19 patients, no history of pre-existing co morbidities or any family, past, personal history and complete details of patients with their management. All the case reports were identified in PubMed and Sciencedirect database. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A total of 14537 studies were screened and 46 case reports were included in this review. In 46 case reports, there were 49 patients (three case reports had two patients) in which 32 were males and 17 were females. Majority of the patients experienced neurological manifestations followed by gastrointestinal manifestations, haematological manifestations and ocular manifestations. Health care professionals should be aware and alert about unusual extra pulmonary clinical manifestations of COVID-19 patients; this would help in making timely diagnosis and accurate treatment of COVID-19 patients.
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22. Guotao L, Xingpeng Z, Zhihui D, Huirui W. SARS-CoV-2 infection presenting with hematochezia. Med Mal Infect. 2020;50(3):293–6.
23. Banerjee TK, Sarkar AK, Karpurakayastha S, et al. Conus myelitis associated with covid-19 infection- report of a case. J Assoc Physicians India. 2021;69(6):11-12.
24. Natarajan S, Ganesh R, Palaniappan N, Kannan L. SARS-CoV-2 encephalitis in an adolescent girl. Indian Pediatr. 2020;57(12):1186–7.
25. Urso L, Distefano MG, Cambula G, et al. The case of encephalitis in a COVID-19 pediatric patient. Neurol Sci. 2022;43(1):105–12.
26. Amarapurkar AD, Vichare P, Pandya N, Deshpande S. Haemorrhagic enteritis and COVID-19: causality or coincidence. J Clin Pathol. 2020 Oct;73(10):686.
27. Gupta S, Kaushik A, Kest H, et al. Severe enteritis as the sole manifestation of novel coronavirus disease 2019 (covid-19) in adolescent patients. Case Rep Infect Dis. 2020;2020:8823622.
28. Singhavi R, Sharma K, Desai HD, Patel R, Jadeja D. A case of hemolytic anemia with acute myocarditis and cardiogenic shock: a rare presentation of covid-19. Cureus. 2020;12(9):e10657.
29. Rehman M, Gondal A, Rehman NU. Atypical Manifestation of COVID-19-Induced Myocarditis. Cureus. 2020;12(6):e8685.
30. Khan IA, Karmakar S, Chakraborty U, Sil A, Chandra A. Purpura fulminans as the presenting manifestation of COVID-19. Postgrad Med J. 2021;97(1149):473.
31. Kumar A, Sahu A, Kaushik J, Arora A, Dubbaka S, Manumala LK. Unilateral submacular hemorrhage: Novel presentation of COVID-19 infection. J Med Virol. 2021;93(7):4122–3.
32. Sharma A, Kudchadkar US, Shirodkar R, Usgaonkar UPS, Naik A. Unilateral inferior altitudinal visual field defect related to COVID-19. Indian J Ophthalmol. 2021;69(4):989–91.
33. Ben-David GS, Halachmi-Eyal O, Shyriaiev H, Brikman S, Dori G, Briscoe D. Diplopia from abducens nerve paresis as a presenting symptom of COVID-19: a case report and review of literature. Arq Bras Oftalmol. 2021;85(2):182–5.
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35. Eleiwa T, Abdelrahman SN, ElSheikh RH, Elhusseiny AM. Orbital inflammatory disease associated with COVID-19 infection. JAAPOS. 2021;25(4):232–4.
36. Georgy JT, Jayakaran JAJ, Jacob AS, et al. Evans syndrome and immune thrombocytopenia in two patients with COVID-19. J Med Virol. 2021;93(5):2642–4.
37. Sadr S, SeyedAlinaghi S, Ghiasvand F, et al. Isolated severe thrombocytopenia in a patient with COVID-19: A case report. IDCases. 2020;21:e00820.
38. Kaushik A, Garg A, Singh BM, Agarwal AK, Wani SN. Hypokalaemic Paralysis Associated with COVID-19 Infection. J Assoc Physicians India. 2021;69(1):78–9.
39. Vasanthapuram VH, Badakere A. Internuclear ophthalmoplegia as a presenting feature in a COVID-19-positive patient. BMJ Case Rep. 2021;14(4):e241873.
40. Rodríguez-Rodríguez MS, Romero-Castro RM, Alvarado-de la Barrera C, González-Cannata MG, García-Morales AK, Ávila-Ríos S. Optic neuritis following SARS-CoV-2 infection. J Neurovirol. 2021;27(2):359–63.
41. Ghosh R, Roy D, Roy D, et al. A Rare Case of SARS-CoV-2 Infection associated with pituitary apoplexy without comorbidities. J Endocr Soc. 2021;5(3):bvaa203.
42. Katti V, Ramamurthy LB, Kanakpur S, Shet SD, Dhoot M. Neuro-ophthalmic presentation of COVID-19 disease: A case report. Indian J Ophthalmol. 2021;69(4):992–4.
43. Ramesh SV, Ramesh PV, Ramesh MK, Padmanabhan V, Rajasekaran R. COVID-19-associated papilledema secondary to cerebral venous thrombosis in a young patient. Indian J
Ophthalmol. 2021;69(3):770–2.
44. Mehrabi Nasab E, Heidarzadeh S, Yavari B, Athari SS. Acute upper limb ischemia in a patient with COVID-19: A case report. Ann Vasc Surg. 2021;77:83–5.
45. Singh B, Kaur P, Ajdir N, Gupta S, Maroules M. Covid-19 presenting as acute limb ischemia. Cureus. 12(7):e9344.
46. Nasseh S, Trabelsi MM, Oueslati A, Haloui N, Jerraya H, Nouira R. COVID-19 and gastrointestinal symptoms: A case report of a Mesenteric Large vessel obstruction. Clin Case Rep. 2021;9(6):e04235.
47. Gupta S, Dixit PK, Prasad AS. Myositis in a patient with coronavirus disease 2019: A rare presentation. Med J Armed Forces India. 2021;77:S486–9.
48. Fidan V. New type of corona virus induced acute otitis media in adult. Am J Otolaryngol. 2020;102487.
49. De Sene DR, Watashi DM, Bilitardo I de O, Moreno CEC, Moreno MF de F. COVID-19 presenting as persistent hiccups: a case report. Rev Inst Med Trop Sao Paulo.2021; 63:e62.
50. Lovi NK, Kekrebesi SK, Osei M, Yeboah E. Coronavirus disease 2019 presenting as psychosis: a case report. J Med Case Rep. 2022;16:171.
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| Files | ||
| Issue | Vol 11, No 3 (Summer 2023) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/jpc.v11i3.16013 | |
| Keywords | ||
| COVID-19; Case Reports; Extra Pulmonary | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Hotha P, Gupta R. Unusual Extra Pulmonary Clinical Manifestation as Initial Presenting Feature of COVID-19 and its Management: A Systematic Review of Case Reports. J Pharm Care. 2023;11(3):173-187.
