A Unique Presentation of Delirium in a Patient with Otherwise Asymptomatic COVID-19.

2020 
IMPORTANCE: Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease (COVID-19), manifests with a wide spectrum of presentations. Most reports of COVID-19 highlight fever and upper respiratory symptoms as the dominant initial presentations, consistent with the World Health Organization guidelines regarding suspected SARS-CoV-2 infection. However, atypical presentations of this disease have been evolving since the initial outbreak of the pandemic in December 2019. OBJECTIVE: Here, we report a case of an older male patient who presented at our hospital with an unusual manifestation of COVID-19. DESIGN: Brief report. SETTING: A university hospital in Saudi Arabia. INTERVENTION: The patient was initially admitted with delirium and underwent a further work-up. INTERVENTION: He was initially admitted with delirium and was subjected to a further work-up. MAIN OUTCOMES AND MEASURES: Given his recent history of domestic travel and the declaration of a global COVID-19 pandemic status, he was subjected to a swab test for SARS-CoV-2. RESULTS: The patient's positive test led to a diagnosis of COVID-19. Although he began to experience a spiking fever and mild upper respiratory symptoms, he recovered rapidly with no residual sequela. CONCLUSIONS AND RELEVANCE: The recognition of atypical presentations of COVID-19 infection, such as delirium, is critical to the timely diagnosis, provision of appropriate care, and avoidance of outbreaks within healthcare facilities during this pandemic. This article is protected by copyright. All rights reserved.
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