一名新冠肺炎患者的急性体温过低:病例报告及证据总结
Acute hypothermia in a patient with COVID-19: a case report and summary of the evidence.
作者信息
Jyoti Avijit Sarker, Kamrul-Hasan A B M, Rahman Monjur, Hasan Mohammad Jahid
机构信息
Department of Medicine, Mugda Medical College.
Department of Endocrinology, Mymensingh Medical College, Mymensingh, Bangladesh.
出版信息
Ann Med Surg (Lond). 2024 Jan 11;86(3):1691-1694. doi: 10.1097/MS9.0000000000001709. eCollection 2024 Mar.
INTRODUCTION AND IMPORTANCE
SARS-COV-2 has many presenting signs including a number of typical and atypical symptoms. However, having the enormous capacity of mutation, the virus is changing its genetic pattern continuously, giving rise to newer and rarer manifestations. Here, the authors report a case of adult COVID-19 along with features of hypothermia which is relatively rare and has future implications in clinical perspective.
CASE PRESENTATION
The patient presented with hypothermia and indicative symptoms of COVID-19 during admission. Comorbidities were assessed, potential differentials were ruled out thorough appropriate clinical examination and investigations. Insulation with a blanket and room heater was used to stabilize the normal body temperature (98.6°F) in the hospital setting, during this period vitals (Blood pressure, Pulse rate and oxygen saturation) were assessed regularly. On the sixth day of hospital admission, he was discharged from the hospital with advice.
CLINICAL DISCUSSION
COVID-19 virus can enter into brain through olfactory tract and may cause dysfunction in the medial preoptic area of the hypothalamus containing warm sensitive neurons directly or via cytokine-induced release of prostaglandin E2 from endothelial cells, which acts through a paracrine mechanism that may provoke hypothermia in our case.
CONCLUSIONS
This case highlights a rare presentation of COVID-19 infection that has not been thoroughly explored. The authors believe the case report holds particular importance especially in dealing with COVID-19 cases in both clinical and home settings.
引言与重要性
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)有许多表现体征,包括一些典型和非典型症状。然而,该病毒具有巨大的突变能力,其基因模式在不断变化,从而产生更新颖和罕见的表现形式。在此,作者报告一例成年新冠肺炎病例,伴有体温过低的特征,这相对罕见,且从临床角度来看具有未来意义。
病例介绍
患者入院时出现体温过低及新冠肺炎的指示性症状。评估了合并症,通过全面适当的临床检查和调查排除了潜在的鉴别诊断。在医院环境中,使用毯子和房间加热器保暖以稳定正常体温(98.6°F),在此期间定期评估生命体征(血压、脉搏率和血氧饱和度)。入院第六天,他在得到建议后出院。
临床讨论
新冠肺炎病毒可通过嗅觉通路进入大脑,可能直接或通过细胞因子诱导内皮细胞释放前列腺素E2,导致含有温敏神经元的下丘脑视前内侧区功能障碍,前列腺素E2通过旁分泌机制发挥作用,在我们的病例中可能引发体温过低。
结论
本病例突出了新冠肺炎感染一种尚未被充分探索的罕见表现。作者认为该病例报告具有特别重要的意义,尤其是在临床和家庭环境中处理新冠肺炎病例时。