Dizziness can be an early sole clinical manifestation for COVID‐19 infection: A case report

Sia, Jacky

SARS‐CoV‐2 is a novel strain of coronavirus that was first identified in Wuhan, China; it has since spread rapidly throughout the world. Most of the patients with COVID‐19 present with respiratory symptoms, including cough, nasal symptoms, fever, and shortness of breath. However, several groups have reported that SARS‐CoV‐2 can infect the central nervous system via the olfactory bulb followed by spread throughout the brain and peripheral nervous system. This brief report illustrated a 78‐year‐old man who presented to the emergency department (ED) on March 22, 2020, with chief complaints of dizziness and unsteadiness while walking. He had no symptoms suggestive of COVID‐19 on arrival. SARS‐CoV‐2 nasopharyngeal swab test performed at that time due to his atypical presentation and lymphocytopenia was positive for virus nucleic acids. The neurological symptoms associated with COVID‐19 are frequently non‐specific and may emerge several days before the respiratory symptoms; as such, identification of patients presenting with these subtle and seemingly unremarkable COVID‐19 symptoms will be quite difficult. Added to this, numerous countries still limit testing for SARS‐COV‐2 to patients presenting with fever or respiratory symptoms. Frontline physicians should be aware of early, non‐specific symptoms associated with SARS‐CoV‐2 infection.