Late diagnosis of severe covid-19 later complicated several life-threatening complications misdiagnosed solely for concomitant severe malaria initially: A case report

Abstract

Severe forms of coronavirus disease 2019 (COVID-19) are the main causes of COVID-19-related deaths due to their life-threatening complications which often warrant intensive care management to improve patients’ outcomes. We herein, present a case of severe COVID-19 with several critical complications in an Intensive Care Physician misdiagnosed initially for severe malaria and later adequately diagnosed and managed successfully at Douala General Hospital in Cameroon. We report a case of a 35-year-old obese African Anaesthesiologist and Intensive Care Physician with a recent history of exposure to COVID-19 patients who presented to the emergency department with signs, symptoms and laboratory test suggestive of severe malaria. He had no remission with parenteral anti-malarial drugs. Within some few days he developed pulmonary embolism, myocardial infarction, septic shock, acute kidney injury and mild hepatocellur lysis and had a positive reverse time-polymerase chain reaction (RT-PCR) to COVID-19. His outcome was uneventful within five days of intensive care management and close monitoring. The case pinpoints the common practice of misdiagnosing COVID-19 for severe malaria especially in patients without respiratory symptoms in our malaria endemic zone. This often leads to late diagnoses of COVID-19 with several potentially life-threatening complications which may lead to a fatal outcome of the patient if not managed appropriately. Hence, a high index of clinical suspicion of COVID-19 remains paramount especially for those with COVID-19 risk factors such recent exposure to COVID-19 patient and obesity.