Coexistence of carbon monoxide intoxication and COVID-19

Introduction This case report aimed to report two patients admitted to the emergency department with a preliminary diagnosis of carbon monoxide intoxication and was diagnosed with COVID-19 during their follow-up. Case 1 A 73-year-old female patient presented with weakness and shortness of breath complaints to the emergency department. Carboxyhemoglobin (COhgb) reached 36.2 %. Atypical pneumonic infiltration with peripheral and central patchy consolidations in the zones in hemothorax images from computerized tomography. The patient was tested positive for COVID-19 after a PCR test. The COhgb values of the patient reached 16 % after 3 h. Then, it dropped to 3.0 % after 8 h. Case 2 A 77-year-old male patient presented with shortness of breath and nausea complaints to the emergency department. COhgb (carboxyhemoglobin) reached 30%. Emphysematous changes in the lung parenchyma and increased peribronchial densities in the lobes were shown in computed tomography. The patient was tested positive for COVID-19 after a PCR test. The COhgb values of the patient reached 13 after 3 h. It dropped to 2.4 after 8 h. Conclusion Carbon monoxide intoxication is a significant public health problem with a high probability of death. Detailed studies and meta-analyses are needed to affect the prognosis of COVID-19 disease.

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  • Qin W, Chen S, Zhang Y, Dong F, Zhang Z, Hu B et al. Diffusion capacity abnormalities for carbon monoxide in patients with COVID-19 at 3-month follow-up. Eur Respir J 2021; 58: 2003677 .Doi: 10.1183/ 13993003.03677-2020.
  • Öktem B, Üzer F, Güven FMK, Kırhan İ, Topal M. Role of methemoglobin and carboxyhemoglobin levels in predicting COVID-19 prognosis: an observational study. Med Gas Res. 2020;10(4):174-178.
  • Kerget B, Kerget F, Koçak AO, Akbaş İ, Araz Ö, Uçar EY et al. Is endogenous carboxyhaemoglobin level a useful biomarker of clinical course and prognosis in COVID-19 patients? Int J Clin Pract. 2021;75:e14680. Doi:10.1111/ijcp.14680.
  • Paccaud P, Castanares Zapatero D, Gérard L, Montiel V, Wittebole X, Collienne C et. al. Arterial Carboxyhemoglobin Levels In COVID-19 Critically Ill Patients. Research Square. (2021) https://doi.org/10.21203/rs.3.rs-68522/v2 .
  • Özdemir S, Altunok İ, Eroğlu SE. Relationship Between Carbon Monoxide Poisoning, Lactate and Cardiac Marker. Van Med J. 2019;26(3):285-8. Doi: 10.5505/vtd.2019.24993.
  • Faisal H, Ali ST, Xu J, Nisar T, Sabawi M, Salazar E et al. Carboxyhemoglobinemia in Critically Ill Coronavirus Disease 2019 Patients. J. Clin. Med. 2021;10:2731. Doi:10.3390/jcm10122731.
  • Faisal H, Bloom A, Gaber AO. Unexplained Methemoglobinemia in Coronavirus Disease 2019: A Case Report. A&A Practice. 2020;14(9):e01287 Doi: 10.1213/XAA.0000000000001287.