Case of a 32 years old female with post covid syndrome .

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This is the case of a 32 years old female , with an established profession and resident of Chandigarh .

CHIEF COMPLAINT

The patient has the chief complaint of

• Chest pain from one month.
• Brain fogging from 15 days.
• Lack of attention from 15 days.
• Tinnitus from 15 days .

HISTORY OF PRESENTING ILLNESS

The patient was apparently asymptomatic 9 months ago , when she had a fever not associated with chills and rigor ( lasted for 4 days) , cough ( that lasted for 10 days ) and body ache , following which she tested COVID positive . She took symptomatic treatment .

5 months ago , the patient again , got a fever , dry cough ( that lasted for 7 days) and a feeling of exhaustion .She suspected it to be COVID , but was not tested and isolated herself . She took symptomatic treatment . 

1 month ago , the patient started experiencing headache and generalised body pain. After 2 days , she got a fever not associated with chills and rigor (temperatures between 99-100 degrees Fahrenheit ) and dry cough that lasted for 4 days .She suspected it to be COVID again , but was not tested . She took symptomatic treatment .

After the above symptoms subsided , the patient started experiencing brain fogging( the patient described it as a sense of generalised weakness , loss of energy and  lack of attention )  .The brain fogging sensation was initially present for 2-3 days after the fever and cough subsided , then suddenly disappeared for two days and started again . The patient was not able to work for more than 2 to 2.5 hours .The sensation of brain fogging would usually start in the afternoon after office work and would reduce after eating and taking rest . On the day the brain fogging started again ,the patient experienced numbness in the left ear and reduced hearing ( not associated with pain or any discharge ), that lasted only one day .

She also complains of tinnitus like ringing or buzzing sound predominantly in the left ear , from the day brain fogging started again( from 12-13 days) ,that is present throughout the day and is heard more in quiet surroundings. The tinnitus was reduced 1 day ago.

 She also has chest pain, predominantly on the left side of the chest from the past 1 month . The pain was initially on and off ( Initially once a week then 2-3 times a week ) aggravated with office work and reduced after rest . The patient described it to be a muscular pain or pinching type of pain . The pain did not radiate to any other area . After her recent bout of COVID in September , the pain has become continuous . The pain does not hinder with daily work. 

HISTORY OF PAST ILLNESS

Not a known case of DM, hypertension, asthma, TB, Thyroid condition, CVD, or Epilepsy.

FAMILY HISTORY

Father- Known case of DM

PERSONAL HISTORY

Appetite- Normal 

Diet- Veg 

Sleep- Disturbed from 18 days ( after 3 rd bout of COVID ) . The patient wakes up at different times at night and then cannot sleep .

Bowel and bladder movements- Regular

Alcohol- no

Smoking- no

Allergies- no

The patient has taken three doses of COVID vaccine.

INVESTIGATIONS