Cough in times of coronavirus

Abstract

The article describes the case of a hospitalized 58-year-old female patient with a chronic dry cough and increased inflammation values. Before hospital admission, the presence of coronavirus disease 2019 (COVID-19) was excluded by a normal chest X‑ray and two negative PCR tests on throat swabs. On admission the only symptom was a dry cough with clinically inconspicuous auscultation findings. The laboratory investigations revealed anemia and increased inflammation parameters, e.g. C‑reactive protein (CRP) 92.4 mg/l and erythrocyte sedimentation rate (ESR) 102 mm/h (according to Westergren). A large vessel vasculitis was demonstrated on magnetic resonance angiography (MRA). After the diagnosis of a giant cell arteritis, treatment with an oral glucocorticoid and subcutaneous methotrexate (MTX) was initiated, with good clinical and laboratory parameter responses. Dry cough has been described in rare cases in the literature as the first sign of large vessel vasculitis.