One disease, many faces-typical and atypical presentations of SARS-CoV-2 infection-related COVID-19 disease

Core Tip

Core Tip: The novel severe acute respiratory syndrome-coronavirus-2 virus causing coronavirus disease 2019 (COVID-19) pandemic can present with typical or atypical symptoms and signs. Classical clinical presentation includes fever, cough, and sore throat with or without other associated symptoms such as anorexia, nausea, and lethargy in the presence or absence of pneumonia, which is commonly noted as ground-glass opacities on chest imaging. Gastrointestinal and hepatic involvement is very non-specific, but diarrhoea is known to predominate in some patients in the absence of typical symptoms and signs. Other systems involvement include electrographic abnormalities associated with clinical events such as syncope, viral myocarditis-related cardiac failure, meningoencephalitis, and acute inflammatory demyelinating polyneuropathy, a dermatological presentation with diffuse urticaria or viral exanthem, smell and taste dysfunction and local and systemic venous thromboembolism. Other rare presentations include keratoconjunctivitis and otitis media. Physicians caring for, and battling on the frontlines against COVID-19 should be aware of the “many faces” that this singular disease can present with, for timely diagnosis and prompt initiation of best treatment options.