Case Report: Two Cases of Persistent Hiccups Complicating COVID-19 (original) (raw)
Related papers
Persistent hiccups after acute COVID-19 successfully treated with chlorpromazine: a case report
Journal of medical case reports, 2024
Introduction 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. Case presentation 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. Conclusion 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.
Cureus, 2021
The possibilities of coronavirus disease 2019 (COVID-19) to present with atypical manifestations have reported. Information of COVID-19 atypical signs and symptoms is still emerging globally. One of these presentations is persistent hiccups. One of the hypotheses is that COVID-19 has been linked to several neurological manifestations and effects. Some observations noticed phrenic nerve paralysis after COVID-19 infection leading to pulmonary failure. We report one case of COVID-19-positive patient where he presented with persistent hiccups. Many predisposing factors might lead to the development of hiccups in COVID-19 infection such as a history of smoking, phrenic and vagus nerve damage or irritation, high inflammatory markers, lower lobe pneumonia, ground-glass-like appearance on x-rays. We hypothesize that hiccups are the first sign of serious deterioration of patients with COVID-19 and such patients are at high risk of developing kidney injury and intubation.
Frontiers in Neurology
Symptoms, such as fever, dry cough, dyspnoea, and respiratory distress, are commonly described in patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Recently, a growing number of cases pertained to persistent hiccups have been reported by SARS-CoV-2 infected patients. The aim of this systematic review was to screen the current literature and provide a summary of the reported cases of SARS-CoV-2 infected patients presenting with persistent hiccups. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, Scopus, and Web of Science databases were searched from inception until October 2021. Case reports or case series that provided a separate clinical description for patients with presenting complaints of persistent hiccups before or after COVID-19 diagnosis were retrieved. The critical appraisal checklist for case reports provided by the Joanna Briggs Institute (JBI) was employed to evaluate the over...
Journal Of Family Medicine And Primary Care, 2021
Coronavirus disease (COVID-19) is the newly discovered infectious disease, affecting millions worldwide. Majority of the patients present with mild respiratory syndrome. Some neurological symptoms are reported like anosmia & dysgeusia. We are presenting a case with hiccups as an unusual symptom. An elderly male patient presented to Bapuji teaching hospital attached to JJM medical college, Davangere on 24th July 2020 with intractable hiccups in the last 5 days. There were no other symptoms. Patient's saturation was initially 98% at room air which then dropped to 90%. Based on clinical knowhow, SARS-Cov-2 RNA qualitative RT-PCR test was sent, and the results came positive. Patient improved symptomatically in 2 days and was kept in ward for observation for a total of 7 days. This extremely rare case report brings to light new atypical symptom of COVID-19 are being presented every other day, which shows how the importance being aware of the same. Keywords: COVID-19, Hiccups, Hyponatremia
Germs, 2022
IntroductionAmong the less common symptoms associated with the SARS-CoV-2 infection the attention is drawn by a persistent hiccup that was recently quoted in the literature.Case reportWe present the case of a 46-year-old Caucasian male patient hospitalized in the Infectious Diseases Clinic of the Academic Emergency Hospital Sibiu, Romania with laboratory confirmation of SARS-CoV-2 infection with a positive result of real-time reverse transcriptase–polymerase chain reaction (RT-PCR) assay from nasopharyngeal swabs, that during the disease course developed persistent hiccup associated with the administration of cortisone therapy, dexamethasone. A decision to stop the treatment with cortisone preparations was made, with the disappearance of the hiccup after 36 hours.ConclusionsFrom our experience, other cases of SARS-CoV-2 infection that we managed during these months of the pandemic, with mild or severe forms of the disease, showed hiccup under treatment with dexamethasone, an event also described in other medical conditions under the same treatment and improved at its cessation or when replaced by methylprednisolone.
Systemic review: the pathogenesis and pharmacological treatment of hiccups
Alimentary pharmacology & therapeutics, 2015
Hiccups are familiar to everyone, but remain poorly understood. Acute hiccups can often be terminated by physical manoeuvres. In contrast, persistent and intractable hiccups that continue for days or months are rare, but can be distressing and difficult to treat. To review the management of hiccups, including a systematic review of reported efficacy and safety of pharmacological treatments. Available articles were identified using three electronic databases in addition to hand searching of published articles. Inclusion criteria were any reports of pharmaceutical therapy of 'hiccup(s)', 'hiccough(s)' or 'singultus' in English or German. Treatment of 341 patients with persistent or intractable hiccups was reported in 15 published studies. Management was most effective when directed at the underlying condition. An empirical trial of anti-reflux therapy may be appropriate. If the underlying cause is not known or not treatable, then a range of pharmacological agen...
The Pathophysiology of Hiccups- a Comprehensive Review
2021
A hiccup is a sudden, repetitive involuntary contraction of the diaphragm and the intercostal muscles immediately followed by laryngeal closure. Hiccups are usually self-limiting, lasting up to a few minutes without any major clinical significance or the need for medical assistance. It may be the result of factors that trigger any of the three components of the reflex arc viz. the afferent limb, central limbic system or the efferent limb or any combination of neurotransmitters that assist the reflex arc. Despite its common occurrence, the pathophysiology and management of hiccups still remains unclear. Recent literature primarily consist of case reports which support the broad evidence of the numerous etiological factors and various drug treatments. Generally considered harmless, episodes of persistent or intractable hiccups may tend to have an underlying sinister pathology which may be easily overlooked. The etiopathogenesis has most often been attributed to lesions of the central ...