![]() The more serious forms cause pneumonia up to acute respiratory distress, requiring hospitalization in intensive care. Finally, recent medical findings also describe the possibility of skin damage, related to peripheral vascular disorder, in patients with COVID-19. Anosmia and ageusia have also been reported in cases of COVID-19 and can be early signs of the disease. These include digestive signs such as diarrhoea in a quarter of cases, and anorexia and nausea in 18% of patients. Other symptoms were initially described as atypical. Symptoms such as headache, sore throat or nasal obstruction are less common. The acute clinical picture of COVID-19, which can be compared to a severe influenza syndrome, classically involves a nearly constant fever, cough in more than 2/3 of cases, dyspnoea in more than half of patients, asthenia in 38 to 44% of cases, myalgia in 44% of patients and production of sputum in 1/3 of cases. To our knowledge, no case of long-term painless non-inflammatory tracheal hypersecretion has been attributed to COVID-19 in the literature. The patient has given his consent for this publication. The otorhinolaryngology examination remained normal. The tracheal hypersecretion persisted for 3 months and then progressively decreased, but it did not resolve completely. Inspection of the mouth and throat found no inflammatory lesions or any other atypical features. During follow-up he specified that the phenomenon was not bronchopulmonary but a painless tracheal hyperproduction of mucus, and he denied consuming any unusual food or drink. The hypersecretion was exacerbated in the decubitus position, forcing the patient to get up and spit frequently to relieve the sensation of tracheal obstruction. The patient did not have a sore throat, indicating that the secretions were not the result of an inflammatory phenomenon. However, tracheal hypersecretion appeared in the form of thick, white mucus. After 5 days the fever, dry cough, dysgeusia and headache vanished, and the asthenia significantly decreased. The course of the disease was progressively positive. His sick leave was extended by 14 days and the paracetamol continued, in addition to rest and regular follow-up with his GP. The patient’s health status was not considered to be of concern and he was not hospitalized. ![]() In the meantime, other symptoms had appeared including a dry cough, dysgeusia and headache. ![]() The patient was given 2 days of sick leave and prescribed paracetamol for his symptoms, and he was sent for COVID-19 screening by the polymerase chain reaction test. When he continued to feel very tired despite the weekend rest, he consulted his GP, who found a fever of 39.2☌. The first symptom, asthenia, occurred at the weekend and the patient had initially attributed it to an exhausting work week. He did not smoke or drink alcohol and he did not take any regular treatment. He had no particular medical history, including no heart or vascular disease, respiratory condition, diabetes, kidney failure, immune deficiency or obesity. A 49-year-old man consulted his general practitioner (GP) for significant and unusual asthenia. ![]()
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