Patient History

A 29-year-old man with no history of fever underwent a weight loss of 14 kgs in the previous 5 months presents with a history of nonproductive cough. There was no history of fever.&nbsp;

In addition, he had had moderate exertional dyspnea, asthenia, adynamia, and weight loss of about 14 kgs in the previous 5 months. Being a patient with an acute respiratory condition and suspicion of COVID-19, real-time PCR (RT-PCR) was used to confirm a SARS-CoV-2 infection from a nasopharyngeal swab.

Laboratory Investigations

At the time of hospital admission, the patient showed:

<ul>
	<li>Absence of leukocytosis</li>
	<li>Mild neutrophilia (80%) and marked lymphopenia (4.1%), and mild anemia (9.9 g/dL) without alterations in the platelet series.</li>
	<li>C-reactive protein was increased (184.7 mg/L),&nbsp;</li>
	<li>Ferritin was elevated (&gt; 2,000 ng/dL)</li>
	<li>D-dimer reached 4,600 ng/mL, and procalcitonin was 5.76 ng/mL</li>
	<li>Respiratory frequency was 35.</li>
	<li>Oxygen saturation was less than 90%.&nbsp;</li>
	<li>Outpatient sputum analysis: positive for infection with Mycobacterium tuberculosis without resistance to rifampicin</li>
	<li>Routine evaluation with confirmatory tests showed coinfection with HIV, with a viral load of 78,100 copies/mL and a CD3/4+ level of 133 C/&micro;L.</li>
</ul>

COVID Cases

Medisage Internal Medicine Community

Explore a case of a 29-year-old man with COVID-19 and tuberculosis coinfection, highlighting symptoms, lab findings, and diagnostic challenges.

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