An Important Clinical Condition in Differential Diagnosis of Coronavirus Disease 2019: Crack Lung.

Abstract

Crack cocaine has been associated with a variety of pulmonary manifestations. We report a 44-year-old man been diagnosed with severe acute respiratory syndrome coronavirus 2 infection, presenting shortness of breath, non-productive cough, chest pain, headache, dizziness, and fever lasting for 2 days. At first, all findings of our patient called for an impression of coronavirus disease 2019. During admission, he presented with acute respiratory symptoms, patchy ground-glass opacities, and laboratory abnormalities, such as elevated acute phase response and lymphopenia. After, the presence of transient lung infiltrations in the follow-up triggered the cause for a re-evaluation of the diagnosis of coronavirus disease 2019. After a detailed inquiry, it was revealed that he had had a history of intense inhaled cocaine use 2 days before hospitalization. We speculate that the crack lung should also be considered in the differential diagnosis in patients with suspected coronavirus disease 2019 pneumonia.