HIV and TB Unit, Department of Infectious Diseases, Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia.
J Med Case Rep. 2024 Jun 19;18(1):294. doi: 10.1186/s13256-024-04500-8.
Hiccups are among the rare complications of COVID-19 infections. There are several published reports of persistent hiccups presenting during the acute COVID-19 period. However, there are very few published reports of persistent hiccups occurring in the post-acute COVID-19 period. Consequently, most clinicians may not be aware of this rare presentation. This case highlights an atypical presentation of persistent hiccups that manifested during the post-acute COVID -19 period that clinicians need to be aware of. The caseadds to the ever increasing body of knowledge about symptoms and signs associated with Severe Acute Respiratory Syndrome Corona Virus type 2 (SARS CoV-2) infection.
A 27 year old male black Zambian patient presented to the emergency department of our hospital with persistent hiccup, 35 days after the initial acute episode of COVID-19. This was associated with breathlessness. There were no other symptoms. He had no history of pulmonary, gastrointestinal, neurological disease or malignancy. He did not take any alcohol or smoke. He had never used any recreational drugs. He was employed as a monitoring and evaluation officer at one of the main COVID centres in the capital. On examination, the patient was anxious. Blood pressure was 141/82, pulse rate was 95 beats per minute, respiratory rate was 26 breaths per minute, temperature was 36.8C and oxygen saturation was 97% on room air. Systemic examination was normal. Chest X-ray and abdominal ultrasonography were normal. A rapid COVID-19 antigen test, and COVID-19 Polymerase Chain Reaction (PCR) test that were done the following day were negative. All other haematological and biochemical tests, including D-dimer and C-reactive protein (CRP), were also normal. A diagnosis of post-acute COVID-19 associated hiccups was made. The patient responded well to treatment with chlorpromazine 25 mg 8 hourly. The hiccups disappeared completely after the fourth dose of chlorpromazine.
This is one of the few published cases of COVID-19 associated persistent hiccups, occurring more than a month after the initial presentation. Most of the published cases report hiccups occurring in the acute COVID-19 period. Consequently, hiccups occurring in the post-acute COVID-19 period may not be attributable to COVID-19. This case has highlighted the need to consider post-acute COVID-19 in the differential diagnosis of persistent hiccup.
打嗝是 COVID-19 感染的罕见并发症之一。有几篇已发表的报告描述了在急性 COVID-19 期间持续打嗝的情况。然而，在 COVID-19 后期间发生持续性打嗝的报道却很少。因此，大多数临床医生可能没有意识到这种罕见的表现。本病例突出了一种在 COVID-19 后期间出现的持续性打嗝的非典型表现，临床医生需要对此有所了解。该病例增加了与严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）感染相关的症状和体征的不断增加的知识体系。
一名 27 岁的男性赞比亚黑人患者在 COVID-19 急性发作后 35 天因持续性打嗝而到我们医院的急诊科就诊。同时还伴有呼吸困难。没有其他症状。他没有肺部、胃肠道、神经或恶性疾病的病史。他不饮酒或吸烟。他从未使用过任何娱乐性药物。他受雇于首都的一个主要 COVID 中心的监测和评估官员。体格检查时，患者焦虑不安。血压为 141/82mmHg，脉搏率为 95 次/分钟，呼吸频率为 26 次/分钟，体温为 36.8°C，室内空气氧饱和度为 97%。全身检查正常。胸部 X 线和腹部超声正常。次日进行的快速 COVID-19 抗原检测和 COVID-19 聚合酶链反应（PCR）检测均为阴性。所有其他血液和生化检查，包括 D-二聚体和 C 反应蛋白（CRP），也均正常。诊断为 COVID-19 后持续性打嗝。患者对氯丙嗪 25mg，每 8 小时一次的治疗反应良好。氯丙嗪使用第四剂后，打嗝完全消失。
这是少数已发表的 COVID-19 相关持续性打嗝病例之一，发生在初次发作后一个多月。大多数已发表的病例报告称，打嗝发生在急性 COVID-19 期间。因此，在 COVID-19 后期间发生的打嗝可能与 COVID-19 无关。本病例强调了在持续性打嗝的鉴别诊断中需要考虑 COVID-19 后期间。
