Rodriguez Jose A, Roa Alejandra A, Lemos-Ramirez Juan C
Memorial Hospital West, Memorial Healthcare System, Pembroke Pines, FL, USA.
Division of Infectious Disease, Memorial Regional Hospital, Memorial Healthcare System, Hollywood, FL, USA.
Case Rep Pulmonol. 2020 Nov 1;2020:8821289. doi: 10.1155/2020/8821289. eCollection 2020.
Coronavirus 2 (SARS-CoV-2) is the virus associated with the coronavirus disease (COVID-19) causing a pandemic worldwide in 2020. There are other noninfectious diseases that can present exactly as COVID-19, and the management and approach are completely different, hence the importance of understanding and having a wide differential in patients presenting with similar characteristics. . A 23-year-old male, with a history of childhood asthma, presented to the Emergency Department in a hospital in south Florida in the USA with complaints of a 2-day duration of subjective fever, chills, dry cough, dyspnea, and myalgia. His vital signs were blood pressure 135/65 mmHg, temperature 39°C, pulse 134 bpm, respiratory rate 22 breaths per minute, and saturation of oxygen 96% in room air. Laboratory analysis was significant for white blood cells 15.3 × 10/L, ALT 69 U/L, AST 66 U/L, ferritin 375.6 ng/mL, C-reactive protein 27.70 mg/dL, and procalcitonin 1.43 ng/mL. A respiratory pathogen panel (RPP) and a SARS-CoV-2 test were both negative. The patient was given empiric antibiotic treatment and hydroxychloroquine. Two more tests for SARS-CoV-2 were negative, and the patient reported that he smoked marijuana through an e-cigarette. The patient was started on high-dose steroids, and symptoms improved.
COVID-19 is an emergent lung disease that is affecting the population worldwide; many other noninfectious diseases can mimic its presentations and laboratory characteristics; the importance of having a broad differential diagnosis especially in causing confusion during pandemic times is valuable in the management of patients with such presentations, such as EVALI, and glucocorticoids will be indicated in this circumstances.
新型冠状病毒2（SARS-CoV-2）是与冠状病毒病（COVID-19）相关的病毒，于2020年在全球引发大流行。还有其他非传染性疾病可能表现得与COVID-19完全一样，而其管理和治疗方法却截然不同，因此对于具有相似特征的患者，理解并进行广泛鉴别诊断非常重要。一名23岁男性，有儿童哮喘病史，因主诉持续2天的主观发热、寒战、干咳、呼吸困难和肌痛，前往美国佛罗里达州南部一家医院的急诊科就诊。他的生命体征为血压135/65 mmHg、体温39°C、脉搏134次/分钟、呼吸频率22次/分钟、室内空气中氧饱和度96%。实验室分析显示白细胞15.3×10⁹/L、谷丙转氨酶69 U/L、谷草转氨酶66 U/L、铁蛋白375.6 ng/mL、C反应蛋白27.70 mg/dL、降钙素原1.43 ng/mL。呼吸道病原体检测组合（RPP）和SARS-CoV-2检测均为阴性。该患者接受了经验性抗生素治疗和羟氯喹治疗。另外两次SARS-CoV-2检测均为阴性，且患者报告他通过电子烟吸食大麻。患者开始接受大剂量类固醇治疗，症状有所改善。
COVID-19是一种正在影响全球人口的新发肺部疾病；许多其他非传染性疾病可模仿其临床表现和实验室特征；在大流行期间，尤其是在造成混淆时，进行广泛鉴别诊断对于管理此类表现的患者（如电子烟或大麻使用相关肺损伤（EVALI））很有价值，在这种情况下糖皮质激素是适用的。
