Odd and frightening COVID-19 presentations

In the early days of the COVID-19 pandemic, the three most highly recognized symptoms of the disease according to the US Centers for Disease Control and Prevention (CDC) were:

• Fever
• Cough
• Difficulty with breathing and shortness of breadth

These symptoms, then seen more in adults in age group 45 years and older, supported the early impression that COVID-19 was essentially a respiratory disease of adults. As at that time, young children were regarded to be spared or not usually affected by the disease.

Within two week or so of the pandemic being declared, the CDC included the following additional symptoms to COVID-19 presentations:

• Chills
• Muscle pain and aches
• Sore throat
• Diarrhea and other GI symptoms
• New loss of taste and smell

Unusual presentation of COVID-19

As the disease continues to establish itself with spread across the globe, more unusual and troubling presentations are being reported in increasing frequencies in different countries, especially in Europe and the United States. These unusual presentations are seen more in young children between ages 5 – 14 years, adolescents/ young adults between ages 17 – 34 years and the very sick adults with pre-existing conditions.

The unusual presentations include:

• Skin rashes
• Enlarged lymph nodes
• Kawasaki disease (or mucocutaneous lymph node syndrome in children) 
• Increasing tendency to blood clotting
• Stroke
• Pulmonary embolism ( blood clots in the vessels of the lungs
• “COVID-toes” 
• Multi-organ and systems failure (i.e., failure of the heart, kidneys and liver)
• Other neurological complications including agitation, confusion, spastic muscle weakness and other features of encephalopathy (brain damage).

Although a cause and effect relationship has not been proven and the precise mechanism underlying these unusual presentations of COVID-19 remains to be unraveled, it is presently hypothesized by some physicians,  that the SARS-nCov2 coronavirus most likely directly attacks and damages the lining of blood vessels to increase blood clotting potentials as well as evokes an inflammatory storm that promotes sudden and oftentimes fatal blood clotting including multi-organ system damage,

Physicians and indeed the general public across the globe and Africa especially, are urged to be mindful of these unusual COVID-19 disease presentations.

Related:

• COVID-19 isn’t just a respiratory disease. It hits the whole body. 
• Protean manifestations of COVID-19: “Our ignorance is profound” 

Posted: 05. 13.20

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