A typical presentation of COVID-19 in a patient with type 2 diabetes at an urban primary care facility in Accra, Ghana

  • Roberta Lamptey Family Medicine Department, Korle Bu Teaching Hospital, Accra Ghana
  • Stephen T. Engmann ST Manna Mission Hospital, Accra, Ghana
  • Boateng Asante Manna Mission Hospital, Accra, Ghana
  • Ernest Yorke Department of Medicine & Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana
  • Yaw B. Mensah Department of Radiology, University of Ghana Medical School University of Ghana, Accra, Ghana
  • Samuel K. Akoriyea Institutional Care Division, Ghana Health Service, Accra, Ghana
  • Christian Owoo Department of Anaesthesia, University of Ghana Medical School, University of Ghana, Accra, Ghana
  • Henry J. Lawson Department of Community Health, University of Ghana Medical School, University of Ghana, Accra, Ghana
Keywords: COVID-19, diabetes, primary care, low resource country, urban

Abstract

This is a case report of a 55-year-old man with Type 2 Diabetes Mellitus who presented with progressive breathlessness, chest pain and hyperglycaemia. An initial impression of a chest infection was made. Management was initiated with antibiotics, but this was unsuccessful, and he continued to desaturate. A screen for Coronavirus Disease of 2019 (COVID-19) returned positive. There was no prodrome of fever or flu-like illness or known contact with a patient known to have COVID-19. This case is instructive as he didn’t fit the typical case definition for suspected COVID-19. There is significant community spread in Ghana, therefore COVID-19 should be a differential diagnosis in patients who present with hyperglycaemia and respiratory symptoms in the absence of a febrile illness. Primary care doctors must have a high index of suspicion in cases of significant hyperglycaemia and inability to maintain oxygen saturation.
Patients known to have diabetes and those not known to have diabetes may develop hyperglycaemia subsequent to COVID-19. A high index of suspicion is crucial for early identification, notification for testing, isolation, treatment, contact tracing and possible referral or coordination of care with other specialists. Early identification will protect healthcare workers and patients alike from cross-infection.

Published
2020-12-31

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print ISSN: 0016-9560