Bacharaki D, Giannakopoulos P, Markakis K, Papas C, Theodorou A, Zoi V, Tsivgoulis G, Lionaki S. COVID-19 presenting with persistent hiccup and myocardial infarction in a peritoneal dialysis patient: A case report. World J Virol 2022; 11(4): 198-203 [PMID: 36159613 DOI: 10.5501/wjv.v11.i4.198]
Corresponding Author of This Article
Dimitra Bacharaki, MD, PhD, Consultant Physician-Scientist, Department of Nephrology, Attikon University Hospital, Rimini 1, Chaidari 12462, Greece. bacharaki@gmail.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dimitra Bacharaki, Panagiotis Giannakopoulos, Vasiliki Zoi, Sophia Lionaki, Department of Nephrology, Attikon University Hospital, Chaidari 12462, Greece
Konstantinos Markakis, Department of Internal Medicine, Attikon University Hospital, Chaidari 12462, Greece
Christos Papas, Department of Cardiology, Attikon University Hospital, Chaidari 12462, Greece
Aikaterini Theodorou, Georgios Tsivgoulis, Second Department of Neurology, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
Author contributions: Bacharaki D was the attending consultant nephrologist and wrote the article; Giannakopoulos P was the resident nephrologist; Markakis K was the attending physician of the Infectious Department; Papas C was the attending cardiologist; Theodorou A as Resident of Neurology and Tsivgoulis G as Professor of Neurology were the neurologists consulted for hiccup; Zoi V was the peritoneal dialysis nurse; Lionaki S supervised the manuscript and was responsible for the language editing; all authors have read and approved the final manuscript.
Informed consent statement: The study participant provided informed written consent for the case report.
Conflict-of-interest statement: The authors have nothing to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dimitra Bacharaki, MD, PhD, Consultant Physician-Scientist, Department of Nephrology, Attikon University Hospital, Rimini 1, Chaidari 12462, Greece. bacharaki@gmail.com
Received: December 24, 2021 Peer-review started: December 24, 2021 First decision: March 16, 2022 Revised: May 1, 2022 Accepted: June 21, 2022 Article in press: June 21, 2022 Published online: July 25, 2022
Abstract
BACKGROUND
Persistent hiccups, lasting more than 48 h, have been described as an atypical presentation of coronavirus disease 19 (COVID-19) in the general population. To the best of our knowledge, this is the first report of persistent hiccups and non-ST elevation myocardial injury (NSTEMI) as an atypical presentation of COVID-19 in a peritoneal dialysis (PD) patient.
CASE SUMMARY
A 70-year old man, who had been on PD for 3 years with a history of ischemic heart failure and reduced ejection fraction, presented for a scheduled radionuclide myocardial scan. Upon arrival, he complained of anorexia, nausea for 5 d, and unremitting hiccups for the previous 48 h. Clinical and laboratory examinations revealed an NSTEMI plus a positive nasopharyngeal reverse transcriptase polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2. COVID-19 lung involvement was mild and was resolved without specific treatment. Myocardial injury was managed by coronary catheterization and stenting, while hiccups responded only to baclofen per os.
CONCLUSION
Persistent hiccups and NSTEMI can be atypical presentations of COVID-19 in peritoneal dialysis patients, which may be due to involvement of the central nervous system and myocardial injuries.
Core Tip: A 70-year old man with end-stage kidney disease on peritoneal dialysis, presented for a scheduled myocardial scan due to ischemic heart failure. Upon arrival, he complained of persistent hiccups during the last 2 d along with anorexia and vomiting for the last 5 d. He was diagnosed with coronavirus disease 2019 (COVID-19) and non-ST elevation myocardial infarction (NSTEMI). Hiccups and NSTEMI are postulated to represent atypical COVID-19 manifestations involving the nervous system and the heart.
