Aasheesh Mehan

Police Hospital, India

Title: Covid-19 ARDS and silent hypoxia in an immunocompetent adult with negative RT-PCR report following two vaccinations and a precautionary dose

Abstract

Summary: We report case of a 52-year gentle man, clerk at private school with diabetes and underlying coronary artery disease who has been vaccinated with 2 doses and a precautionary dose of Covid-19 and presented with complaints of single episode of dizziness followed by fall in the morning without any weakness, chest pain, palpitation, or any flu like symptoms. On examination signs were out of proportion to the symptoms patient was having (no respiratory distress with severe hypoxia at room air). Initially, he was managed in the lines of aspiration pneumonitis and congestive heart failure. But after not improving clinically with increase o2 requirement, Covid ARDS was suspected. With the supporting evidence of HRCT, he was managed in ICU in the lines of Covid pneumonia and started on steroid therapy. Soon, patient improved symptomatically and was discharged with advice for rehabilitation exercise. This case emphasizes the need to suspect Covid infection clinically despite the absence of symptoms of respiratory distress when the patient is actually in silent/happy hypoxia.

Background: In severe Covid pneumonia, as a result of dysregulated immune response, virus tend to cause lung inflammation and severe sequelae, such as ARDS, respiratory failure, sepsis, multi-organ failure, and death [1]. Covid-19 RT_PCR which is often considered as the screening tool require updating due to emergence of different Covid-19 strains. In such scenario,diagnosing asymptomatic cases poses a difficult challenge; where radiographic tools like CT have proven to be promising. Likewise, Covid vaccination acts as a bridge in reducing symptoms and further reducing the hospitalisations and ICU admission [2]. Vaccine effectiveness studies have demonstrated the benefit of vaccine in reducing severity in the individual [3]. So, often in post vaccinated individual when present with severe disease, alternative diagnoses are considered. This case highlights the possibility of severe Covid pneumonia in fully immunised asymptomatic patient cannot be totally ruled out even after negative RT-PCR.A clinical acquaintance of the physician should always be considered due to variable disease presentation.

Biography

Aasheesh Mehan is a practicing physician and incharge of community/public sector in India.He has years of experience in treating patients with wide array of presentations in both outpatient and inpatient.

2nd International Conference on Neuroscience and Neurology

Aasheesh Mehan

Title: Covid-19 ARDS and silent hypoxia in an immunocompetent adult with negative RT-PCR report following two vaccinations and a precautionary dose

Abstract

Biography

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