A Unique Presentation of Delirium in a Patient with Otherwise Asymptomatic COVID‐19

Alkeridy, Walid A.; Almaghlouth, Ibrahim; Alrashed, Rashed; Alayed, Khalid; Binkhamis, Khalifa; Alsharidi, Aynaa; Liu‐Ambrose, Teresa

OBJECTIVE: Infection with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), which causes coronavirus disease 2019 (COVID‐19), manifests with a wide spectrum of presentations. Most reports of COVID‐19 highlight fever and upper respiratory symptoms as the dominant initial presentations, consistent with the World Health Organization guidelines regarding suspected SARS‐CoV‐2 infection. However, atypical presentations of this disease have been evolving since the initial outbreak of the pandemic in December 2019. We report a case of an older male patient who presented at our hospital with an unusual manifestation of COVID‐19. DESIGN: Brief report. SETTING: A university hospital in Saudi Arabia. PARTICIPANT: A 73‐year‐old man who presented with confusion in the absence of any respiratory symptoms or fever. INTERVENTION: The patient was initially admitted with delirium and underwent a further work‐up. MEASUREMENTS: Given his recent history of domestic travel and the declaration of a global COVID‐19 pandemic status, the patient was administered a swab test for SARS‐CoV‐2. RESULTS: The patient's positive test led to a diagnosis of COVID‐19. Although he began to experience a spiking fever and mild upper respiratory symptoms, he recovered rapidly with no residual sequela. CONCLUSION: The recognition of atypical presentations of COVID‐19 infection, such as delirium, is critical to the timely diagnosis, provision of appropriate care, and avoidance of outbreaks within healthcare facilities during this pandemic.