Delayed COVID respiratory failure: what every front line healthcare worker needs to know
The pandemic of COVID-19 has presented several diagnostic challenges in both recognition of acute disease and also the temporal presentation of disease convalescence with return to normal activity. We present a case of delayed clinical progression of COVID-19 associated respiratory failure on day 25...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sciendo
2020-12-01
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| Series: | Romanian Journal of Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.2478/rjim-2020-0022 |
| _version_ | 1818468185849987072 |
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| author | Hedges Mary S. Jackson Kensler D. Matcha Gautam V. Ramakrishna Jahanavi M. Libertin Claudia R. |
| author_facet | Hedges Mary S. Jackson Kensler D. Matcha Gautam V. Ramakrishna Jahanavi M. Libertin Claudia R. |
| author_sort | Hedges Mary S. |
| collection | DOAJ |
| description | The pandemic of COVID-19 has presented several diagnostic challenges in both recognition of acute disease and also the temporal presentation of disease convalescence with return to normal activity. We present a case of delayed clinical progression of COVID-19 associated respiratory failure on day 25 after initial symptom onset and, notably, after initial full resolution of symptoms and negative RT-PCR nasopharyngeal testing. The patient’s delayed presentation of exertional dyspnea and the utilization of specific characteristics of chest radiography in confirmation with laboratory cytokine measurement allowed for clinical re-categorization of the patient’s status to active COVID-19 clinical disease and changed acute management. COVID-19 positive patients should be advised to continue to monitor for respiratory deterioration for a greatly extended period of time, even if RT-PCR testing is negative and initial clinical symptoms have resolved. Frontline healthcare workers, including first responders and primary care providers, also need to be aware to monitor for and recognize this delayed presentation. |
| first_indexed | 2024-04-13T21:10:08Z |
| format | Article |
| id | doaj.art-264b25bc4e7347c696857df27990f3f8 |
| institution | Directory Open Access Journal |
| issn | 2501-062X |
| language | English |
| last_indexed | 2024-04-13T21:10:08Z |
| publishDate | 2020-12-01 |
| publisher | Sciendo |
| record_format | Article |
| series | Romanian Journal of Internal Medicine |
| spelling | doaj.art-264b25bc4e7347c696857df27990f3f82022-12-22T02:29:51ZengSciendoRomanian Journal of Internal Medicine2501-062X2020-12-0158425926310.2478/rjim-2020-0022rjim-2020-0022Delayed COVID respiratory failure: what every front line healthcare worker needs to knowHedges Mary S.0Jackson Kensler D.1Matcha Gautam V.2Ramakrishna Jahanavi M.3Libertin Claudia R.4Department of Medicine, Division of Community Internal Medicine, Mayo Clinic, Jacksonville, FloridaDepartment of Family Medicine, Division of Regional Medicine, Mayo Clinic, Jacksonville, FloridaDepartment of Medicine, Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FloridaDepartment of Medicine, Division of Infectious Diseases, Mayo Clinic, Jacksonville, FloridaDepartment of Medicine, Division of Infectious Diseases, Mayo Clinic, Jacksonville, FloridaThe pandemic of COVID-19 has presented several diagnostic challenges in both recognition of acute disease and also the temporal presentation of disease convalescence with return to normal activity. We present a case of delayed clinical progression of COVID-19 associated respiratory failure on day 25 after initial symptom onset and, notably, after initial full resolution of symptoms and negative RT-PCR nasopharyngeal testing. The patient’s delayed presentation of exertional dyspnea and the utilization of specific characteristics of chest radiography in confirmation with laboratory cytokine measurement allowed for clinical re-categorization of the patient’s status to active COVID-19 clinical disease and changed acute management. COVID-19 positive patients should be advised to continue to monitor for respiratory deterioration for a greatly extended period of time, even if RT-PCR testing is negative and initial clinical symptoms have resolved. Frontline healthcare workers, including first responders and primary care providers, also need to be aware to monitor for and recognize this delayed presentation.https://doi.org/10.2478/rjim-2020-0022covid-19sars-cov-2respiratory failurecytokine release syndromechest radiography |
| spellingShingle | Hedges Mary S. Jackson Kensler D. Matcha Gautam V. Ramakrishna Jahanavi M. Libertin Claudia R. Delayed COVID respiratory failure: what every front line healthcare worker needs to know Romanian Journal of Internal Medicine covid-19 sars-cov-2 respiratory failure cytokine release syndrome chest radiography |
| title | Delayed COVID respiratory failure: what every front line healthcare worker needs to know |
| title_full | Delayed COVID respiratory failure: what every front line healthcare worker needs to know |
| title_fullStr | Delayed COVID respiratory failure: what every front line healthcare worker needs to know |
| title_full_unstemmed | Delayed COVID respiratory failure: what every front line healthcare worker needs to know |
| title_short | Delayed COVID respiratory failure: what every front line healthcare worker needs to know |
| title_sort | delayed covid respiratory failure what every front line healthcare worker needs to know |
| topic | covid-19 sars-cov-2 respiratory failure cytokine release syndrome chest radiography |
| url | https://doi.org/10.2478/rjim-2020-0022 |
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