This article was originally published on Docwire News 

Many symptoms of SARS-CoV-2 (COVID-19) can be concealed due the coexistence of malignant hemopathies such as chronic lymphocytic leukemia (CLL), according to a case report published in The Pan African Medical Journal.

In this case, an elderly man (76 years) who previously underwent surgery for colon cancer was admitted to intensive care for pneumonia. The patient presented with a dry cough, very high fever (104°F), swollen lymph nodes, and diarrhea. A polymerase chain reaction test was conducted and came back positive for COVID-19. A chest CT scan showed pulmonary opacities with consolidation. During his admission, the authors noted that the patient was conscious and breathing 85% at room air with intercostal retraction, with stable hemodynamics: blood pressure, 140/75mmHg; heart rate, 90 bpm; and 39°C fever. Electrocardiogram showed normal sinus rhythm, fixed duration of PR interval, and QTc at 475. Transthoracic echocardiography was normal, they added.

Lab tests conducted on his first day of admission showed the following: elevated white blood cell count at 140020el/mm³ and lymphocytes 129660el/mm³ (vs. 154000el/mm³ at D7), low hemoglobin at 8.9 g/dL, platelets at 464000el/mm³, prothrombin time at 64%, fibrinogen at 6.77 g/L, C-reactive protein at 130 mg/L, brain natriuretic peptide at 249 pcg/L, procalcitonin at 0.017 μg/L, LDH at 331 UI/L, ferritin at 563 μg/L, and troponin at 8.2 ng/L. A blood smeared displayed small lymphocytes with rounded nucleus and reduced cytoplasm. The patient was treated with four daily noninvasive ventilation sessions, hydroxychloroquine (200 mg, twice a day), azithromycin (500 mg/day), ceftriaxone (2 g/day) and moxifloxacin (400 mg twice a day), human immunoglobulins (0.5 g/kg single dose), anticoagulation, proton pump inhibitor, vitamin C, vitamin D, and zinc.