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

Abstract

Importance Infection with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), which causes coronavirus disease (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. Objective Here, 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 He was initially admitted with delirium and was subjected to a further work‐up. Main Outcomes and Measures Given his recent history of domestic travel and the declaration of a global COVID‐19 pandemic status, he was subjected to 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. Conclusions and Relevance 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.