Dyspnea is a Conundrum in the COVID-19 Era - A Case Report

Nithya Rajendran, Ruth Cusack, Keneilwe Malomo, Joseph Browne and Ontefetse Ntlholang

Department of General Medicine, St. James’s Hospital, Dublin, Ireland

^*Correspondance to: Nithya Rajendran 

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Abstract:

Background: In the COVID-19 era, a simple dyspnea can raise diagnostic uncertainties especially when presented with patients with underlying interstitial lung disease or congestive cardiac failure which can both present clinically and radiologically similar to COVID-19 pneumonitis. Moreover, such co-morbidities have an increasingly poorer outcome when associated with SARS-CoV-2
infection.
Case Report: An 85-year-old lady presented with dyspnea a week after being treating for chest infection by general practitioner. Chest X-rays and CTPA showed bilateral airspace opacifications with organizing pattern and SARS-CoV-2 was not detected on three PCR swabs. She was managed with diuretics, antimicrobials, steroids, oxygen and non-invasive ventilation.
Conclusion: An acute exacerbation of ILD, decompensated CCF and CT findings of an organizing pneumonia pattern, raises the possibility of previous SARS-CoV-2 infection being the trigger for the patient’s presentation. Nasal swabs only detect viral shedding, but not the pending cytokine storm thereby posing diagnostical difficulties.

Keywords:

Dyspnea; SARS-CoV-2; Interstitial lung disease; CCF; COVID pneumonia; Covid-19; Covid; Corona Virus; Coronavirus disease 2019

Cite the Article:

Rajendran N, Cusack R, Malomo K, Browne J, Ntlholang O. Dyspnea is a Conundrum in the COVID-19 Era - A
Case Report. Clin Case Rep Int. 2021;5:1233..