SARS-CoV-2 is an RNA virus that causes COVID-19, which has been responsible for the pandemic that was declared in early 2020. Its pathological effect is majorly in the respiratory tract, but its full pathogenicity remains a mystery. Symptoms associated with COVID-19 include fever, cough, and shortness of breath. Some patients develop other symptoms like diarrhea. However, it is possible for other organs to be affected including the central nervous system, liver, and blood cells. The purpose of this case series is to unravel other factors associated with this disease, so we report three cases of COVID-19 that were hospitalized during the pandemic.

The SARS-Cov-2/COVID-19 pandemic in early 2020 has had a devastating impact on health systems around the world. While viral pneumonia remains the most common complication, reports are surfacing of cases with neurological, cardiac, and renal involvement. Even less is known about the implications in special high-risk populations. In this report, we discuss a unique case of an HIV-positive patient in New York City who presented with a 2-week history of worsening fatigue, cough, dyspnea, and myalgias and was found to have COVID-19 pneumonia and acute kidney injury. He was managed for severe uremic metabolic acidosis and electrolyte abnormalities with emergent hemodialysis and supportive therapy with subsequent improvement. Direct involvement of SARS-CoV-2 and pneumonia-induced rhabdomyolysis were identified as the precipitating factors of his acute kidney injury. The pathophysiologic mechanisms of acute kidney injury, SARS-CoV-2 renal tropism, and the impact of highly active antiretroviral therapy on COVID-19 pneumonia are discussed. We highlight the importance of clinician awareness of this potentially fatal complication of COVID-19 pneumonia, particularly in the HIV-positive population as early recognition and management can have favorable outcomes.

First reported in Wuhan, China, Novel Coronavirus Disease-19 rapidly spread causing an outbreak of viral pneumonia and became a pandemic in early 2020. It was later discovered to be caused by Severe Acute Respiratory Syndrome Coronavirus 2, a novel coronavirus. Although the vast majority of cases have primarily involved the respiratory system, some serious cases have started to emerge with central and peripheral nervous system complications. We present the case of a 30-year-old morbidly obese male who initially presented to the emergency department with seizures, altered mental status, and COVID-19 pneumonia. After a 21-day hospital course including 14 days of intensive care unit management, he was stabilized and discharged to a rehabilitation facility. He returned 1 day later with worsening respiratory distress and was found to have acute pulmonary embolism requiring placement of an inferior vena cava filter. After an additional 6 days in the hospital, he was discharged back to the outpatient facility. He returned for a third time with altered mental status, visual and auditory hallucinations, and confabulation. This report provides critical information in revealing a peculiar neurological sequela of COVID-19 induced leukoencephalopathy and its disease course. We hope to shed light on this sequence of events by providing possible mechanisms to aid clinicians in the identification and management of this complication.

The COVID-19 pandemic has drastically affected health care systems globally. Reverse transcriptase-polymerase chain reaction is currently the preferred method of detecting COVID-19; however, sensitivity of this test remains questionable. Incidental transmission and potential harm to infected individuals are some consequences of the failure to identify high-risk patients. We report three cases of symptomatic patients that required intensive care management with labs and imaging consistent with COVID-19 with initial false-negative reverse transcriptase-polymerase chain reaction testing. Improper sampling, viral load, and manufacturer variances of tests all contribute to reduced sensitivity. A clinical diagnosis should supplant such cases.

Background. Although severe pneumonia and respiratory compromise have remained the predominant complications of coronavirus disease 19, we are now learning this virus is much more varied in its presentation. In particular, there are increasingly reported cases of thromboembolic events occurring in infected patients. Case Report. In this report, we present two patients, both under the age of 40 with known risk factors for venous thromboembolism, who presented with respiratory distress. Both patients were diagnosed with SARS-CoV-2 pneumonia and pulmonary embolism requiring management with anticoagulation. Both patients were discharged after a short course in the hospital. Conclusion. The discussion of a hypercoagulable state induced by coronavirus disease 19 has been well documented; however, the exact mechanisms remain unknown. We suspect that a prothrombotic inflammatory response provoked by coronavirus disease could be the culprit, acting as an additive effect on middle-aged patients with known risk factors for venous thromboembolism. We recommend clinicians closely monitor those with known risk factors for pulmonary embolism.