The crown virus: Norwegian doctors with unexpected findings of the crown

“The puzzle will not be finished unless we bring the pieces to the table.”

Martine Rostadmo, a physician and medical editor in the Journal of the Norwegian Medical Association, writes in the article “A Piece of the Puzzle.”

She writes about why case calls, individual patient descriptions, are so important.

“It was a humble letter from a doctor who read that he saw more malformations in his practice and wondered if others had observed the same thing, which triggered the thalidomide scandal,” Rostadmo exemplifies.

In the 1950s and 1960s, the drug thalidomide was sold to help pregnant women with morning sickness. As a result, up to 15,000 children with deformed arms and legs were born.

Covid-19 reports

It is still early in the outbreak of Sars-Cov-2, the new coronavirus that is rapidly spreading worldwide and has already claimed more than 100,000 human lives.

The world is facing something new and dangerous. Medical environments have put their brains in overdrive and are looking for answers, proper treatment, medications and vaccines.

We already know that the most common symptoms of covid-19 coronary heart disease are fever, fast breathing, cough, fatigue, abdominal pain, diarrhea, and decreased appetite.

But it is not always the usual.

Therefore, to prevent the spread of infection and to learn more about this new disease, it is important for the health care system to report when it comes to cases that are not healing as expected.

Therefore, Norwegian doctors have already reported on several unexpected courses of covid-19.

– Findings and advice

– Norwegian doctors have shown that they want to use the Journal as a communication channel during the covid-19 pandemic, both for scientific articles and for discussion material. We are delighted, says physician and deputy chief editor Ragnhild Elise Ørstavik in the Journal of Dagbladet.

So far, they have published 30-40 articles related to the epidemic.

– When we now have a new disease, one that no doctor in Norway has previously treated, the scientific publication in a national medical journal has particularly important meaning, Ørstavik says, explaining:

– By posting with us, physicians and other healthcare professionals can quickly communicate with colleagues across the country with their findings and advice on diagnosing and treating this group of patients.

Until now, Norwegian doctors have written four case studies, individual patient descriptions, dealing with covid-19 cases that it is important to learn from.

Here is a brief presentation of them:

Fall and confusion

Covid-19 detected in elderly women with acute functional impairment, published in the Journal on April 9.

A woman in the late 1980s was referred to an emergency room due to acute functional decline with falls and increasing confusion.

The woman had been found in her home on the floor, and the home nurse perceived her as more confused than she used to be.

The day before, she had become more dizzy than usual and pinched in her nose, but otherwise she had no signs of infection.

She was transferred by ambulance to the emergency room for examination. In the emergency room, the patient did not have a fever, and his blood pressure and heart rate were normal.

When examined in an emergency room at a local hospital, the patient was disoriented and miscounted the course of events.

Clinical and neurological examinations did not respond.

The day after hospitalization, she complained of worsening dizziness, but did not appear to be very ill.

Because her nose was stuffy and she was hospitalized with acute functional failure without proven cause, samples were taken from current respiratory microbes, including Sars-Cov-2.

On day two after admission, he tested positive for the coronavirus.

The woman managed and could eventually be released to her own home despite her age and frailty.

The doctors behind this report point out that many elderly residents and nursing home residents are vulnerable to physical and cognitive dysfunction in acute illness.

Furthermore, they emphasize that health professionals should be aware that rapid loss of function, falls, and delirium can be caused by covid-19.

Loss of taste and smell.

Covid-19 with a sense of smell and reduced taste as the only symptom, published in the Journal on April 3.

A married couple experienced the wife’s lack of sense of smell and husband’s lack of sense of taste a few days after close contact with a person infected with covid-19, the man’s father.

They had no other symptoms, but both had the coronavirus detected.

The wife fried waffles and replied that she did not know the good waffle smell.

She was from previous health and had never had odor or taste disorders or nose / sinus complaints.

She had no fever, sore throat, cough, or trouble breathing.

The patient experienced no symptoms other than complete loss of sense of smell, and both taste and appetite remained unchanged.

16 days after the sense of smell disappeared, the patient could smell a deodorant.

The patient’s husband, including himself in his 60s, experienced complete loss of taste for nine days. He had been in contact with his father seventeen days before the onset of symptoms, in addition to contact with his wife.

He had no cough, sore throat, or respiratory symptoms. Both the sense of smell and appetite did not change.

Since he was in close contact with two confirmed cases of covid-19 and had a complete loss of flavor, he was tested for the coronavirus. The result was positive.

On the tenth day he noticed the bittersweet taste of the strawberries and after 13 days the taste of the good stew.

The doctors behind the report emphasize the importance of identifying patients with few or no symptoms, so that the spread of infection can be controlled.

Doctors also write that these two patients may be sources of infection that are currently under the radar.

Acute abdominal pain

Covid-19 with acute abdominal pain as a debilitating symptom, published in the Journal on March 31.

A woman over 40 years old with acute abdominal pain was admitted on suspicion of inflammation of the gallbladder.

In addition to abdominal pain, he had a fever, vomiting, decreased appetite, and diarrhea.

He had no respiratory symptoms, but was found to have covid-19.

Doctors write that they have observed similarly in various patients in the hospital.

This has led to changes in routines in the evaluation and management of patients with acute abdominal pain.

The doctors behind the report believe that unresolved abdominal pain should be included as a criterion in covid-19’s clarification routines. They believe this can reduce the risk of spreading the infection to patients and hospital staff.

No source of infection is known.

A man in his 90s with a fever and dry cough, published in the Journal on March 20.

A man in his 90s with reduced general condition, fever and dry cough was admitted to regional hospitals when the coronavirus pandemic had just arrived in Norway.

Nothing indicated that he had been infected. He had not been traveling.

The history of the disease shows a serious course in an elderly patient. It also shows the potential for the spread of infection in today’s globalized world.

Despite the lack of exposure to the known Sars-Cov-2 infection, the patient had symptoms that could fit with covid-19.

It was also in the high-risk group with the worst prognosis for covid-19.

The patient was diagnosed with coronary infection on the fifth day of the disease.

Disease On day 8, the patient was in the terminal phase. He died nine days after the onset of symptoms.

Doctors behind the report note that the patient was one of the first to enter Norway with covid-19 and one of the first with proven infection, where there was no clear connection to travel abroad or secure contact with an infected person.

In addition, they note that since there was no suspicion of covid-19, the patient was left without adequate infection control measures on the bed post.