Abstract
Despite SARS-CoV-19 infection has a stereotypical clinical picture, isolated cases with unusual manifestations have been reported, some of them being well-known to be triggered by viral infections. However, the real frequency in COVID-19 is unknown. Analysing data of 63 822 COVID patients attending 50 Spanish emergency department (ED) during the COVID outbreak, before hospitalisation, we report frequencies of (myo)pericarditis (0.71‰), meningoencephalitis (0.25‰), Guillain-Barré syndrome (0.13‰), acute pancreatitis (0.71‰) and spontaneous pneumothorax (0.57‰). Compared with general ED population, COVID patients developed more frequently Guillain-Barré syndrome (odds ratio (OR) 4.55, 95% confidence interval (CI) 2.09-9.90), spontaneous pneumothorax (OR 1.98, 95% CI 1.40-2.79) and (myo)pericarditis (OR 1.45, 95% CI 1.07-1.97), but less frequently pancreatitis (OR 0.44, 95% CI 0.33-0.60).
Highlights
The clinical picture of infection by SARS-CoV-2 is quite stereotypical, being mainly characterised by fever and respiratory symptoms, with dyspnoea and lung infiltrates in the most severe cases [1]
The main objective of the present study was to estimate the relative frequencies for the five abovementioned manifestations (acutepericarditis, meningoencephalitis, Guillain–Barré syndrome, acute pancreatitis and spontaneous pneumothorax) in COVID patients coming to the emergency department (ED) during the COVID-19 outbreak and compare them with the relative frequencies observed in non-COVID ED comers
As part of the Unusual Manifestations of COVID-19 (UMC-19) project, the present study was designed to determine the individual relative frequency of each of the five following entities in COVID patients: acutepericarditis, acute meningoencephalitis, Guillain–Barré syndrome, acute pancreatitis and spontaneous pneumothorax
Summary
The clinical picture of infection by SARS-CoV-2 is quite stereotypical, being mainly characterised by fever and respiratory symptoms, with dyspnoea and lung infiltrates in the most severe cases [1]. Isolated case reports and short case series have communicated unusual clinical manifestations in patients with COVID-19, it is not known if these cases are merely coincidental as the result of complications of patient management or treatments provided during hospitalisation or, alternatively, SARS-CoV-2 predisposes to these manifestations. This is reportedly the case with acute (myo)pericarditis [2, 3], meningoencephalitis [4], Guillain–Barré syndrome [5], acute pancreatitis [6] or spontaneous pneumothorax [7]. We carried out the present study in 50 Spanish EDs included in the SIESTA (Spanish Investigators in Emergency Medicine TeAm) research network
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