“Hiccups” with COVID-19 Management

Abstract

Hiccups, medically referred as singultus, is a condition that results from involuntary contraction of the diaphragm and intercostal muscles. Singultus is usually a self-limiting condition which typically lasts less than 48 hours but in rare cases, can persist greater than 48 hours. This is a case of a 48 year-old male who was prescribed dexamethasone for COVID-19 but developed intractable singultus for two weeks. Patient was unable to tolerate diet due to intractable singultus leading to vomiting. He underwent various non-pharmacological maneuvers and pharmacotherapy without resolution. Dexamethasone- induced hiccups have been reported as an under recognized side effect of dexamethasone. Despite discontinuation of offending agent, patient’s singultus persisted. The patient achieved resolution of singultus with a combination of baclofen and olanzapine. This case provides additional literature during this COVID-19 pandemic while dexamethasone is being used as the first line management.