Prolonged confusional state as first manifestation of COVID-19
Prolonged confusional state as first manifestation of COVID-19
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DOI：
10.1002/acn3.51067
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发表时间：
2020-07-06
影响因子：
5.3
通讯作者：
Geberhiwot, Tarekegn
中科院分区：
文献类型：
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作者：
Butt, Isabel;Sawlani, Vijay;Geberhiwot, Tarekegn
一位77岁的绅士，通常很亮，很好，被承认患有严重的混乱。入院时，格拉斯哥昏迷评分（GCS）为14/15，生命体征在正常范围内，双侧肺底有捻发音。头部CT扫描正常。CXR显示一些空气空间混浊。调查显示低钠血症，CRP升高，COVID-19阳性。通过抗生素和静脉注射生理盐水治疗，钠恢复正常。谵妄在发病后4周保持不变。在COVID-19患者中记录了神经系统表现;然而，没有报告显示谵妄是主要表现。该病例说明急性意识模糊可能是COVID-19的唯一表现症状，而没有明显的肺部疾病。
A 77-year-old gentleman, normally lit and well, was admitted with acute confusion. On admission, Glasgow Coma Scale (GCS) was 14/15, vital signs were within the normal limits and bilateral crepitation at the lung base. Head CT scan was normal. CXR showed some air space opacification. Investigations revealed hyponatraemia, raised CRP, and positive for COVID-19. Treated with antibiotics and intravenous saline, sodium returned to normal. Delirium remained unchanged 4 weeks post-incidence. Neurological manifestations were documented in patients with COVID-19; however no report has shown delirium as a primary manifestation. This case illustrates acute confusion may be the only presenting symptom of COVID-19 without overt lung disease.