背景:打嗝是COVID-19感染的罕见并发症之一。有几篇发表的报道称,在急性COVID-19期间会出现持续的打嗝。然而,关于COVID-19急性发作后持续打嗝的报道很少。因此,大多数临床医生可能不知道这种罕见的表现.该病例突出了在急性COVID-19后期间表现出的持续性打嗝的非典型表现,临床医生需要注意。该病例增加了有关严重急性呼吸系统综合症冠状病毒2型(SARSCoV-2)感染相关症状和体征的知识。
方法:一名27岁的男性黑人赞比亚患者因持续打嗝被送往我院急诊科,在COVID-19首次急性发作后35天。这与呼吸困难有关。没有其他症状。他没有肺部病史,胃肠,神经系统疾病或恶性肿瘤。他没有喝酒或抽烟。他从未使用过任何娱乐性药物。他被聘为首都一个主要的COVID中心的监测和评估官。在检查中,病人很焦虑。血压为141/82,脉搏率为每分钟95次,呼吸频率为每分钟26次呼吸,温度为36.8C,室内空气的氧饱和度为97%。全身检查正常。胸部X线和腹部超声检查正常。一种快速的COVID-19抗原检测,第二天进行的COVID-19聚合酶链反应(PCR)检测均为阴性。所有其他血液和生化检查,包括D-二聚体和C反应蛋白(CRP),也是正常的。诊断为急性后COVID-19相关的打嗝。患者对氯丙嗪25mg每8小时的治疗反应良好。第四剂氯丙嗪后,打嗝完全消失。
结论:这是少数已发表的与COVID-19相关的持续性打嗝病例之一,发生在初次陈述后一个多月。大多数已发表的病例报告打嗝发生在急性COVID-19期间。因此,急性COVID-19后期间发生的打嗝可能与COVID-19无关。该病例强调了在持续性打嗝的鉴别诊断中需要考虑急性后COVID-19。
BACKGROUND: Hiccups are among the rare complications of COVID-19 infections. There are several published
reports of persistent hiccups presenting during the acute COVID-19 period. However, there are very few published
reports of persistent hiccups occurring in the post-acute COVID-19 period. Consequently, most clinicians may not be aware of this rare presentation. This
case highlights an atypical presentation of persistent hiccups that manifested during the post-acute COVID -19 period that clinicians need to be aware of. The caseadds to the ever increasing body of knowledge about symptoms and signs associated with Severe Acute Respiratory Syndrome Corona Virus type 2 (SARS CoV-2) infection.
METHODS: A 27 year old male black Zambian patient presented to the emergency department of our hospital with persistent hiccup, 35 days after the initial acute episode of COVID-19. This was associated with breathlessness. There were no other symptoms. He had no history of pulmonary, gastrointestinal, neurological disease or malignancy. He did not take any alcohol or smoke. He had never used any recreational drugs. He was employed as a monitoring and evaluation officer at one of the main COVID centres in the capital. On examination, the patient was anxious. Blood pressure was 141/82, pulse rate was 95 beats per minute, respiratory rate was 26 breaths per minute, temperature was 36.8C and oxygen saturation was 97% on room air. Systemic examination was normal. Chest X-ray and abdominal ultrasonography were normal. A rapid COVID-19 antigen test, and COVID-19 Polymerase Chain Reaction (PCR) test that were done the following day were negative. All other haematological and biochemical tests, including D-dimer and C-reactive protein (CRP), were also normal. A diagnosis of post-acute COVID-19 associated hiccups was made. The patient responded well to treatment with chlorpromazine 25 mg 8 hourly. The hiccups disappeared completely after the fourth dose of chlorpromazine.
CONCLUSIONS: This is one of the few published cases of COVID-19 associated persistent hiccups, occurring more than a month after the initial presentation. Most of the published cases report hiccups occurring in the acute COVID-19 period. Consequently, hiccups occurring in the post-acute COVID-19 period may not be attributable to COVID-19. This
case has highlighted the need to consider post-acute COVID-19 in the differential diagnosis of persistent hiccup.