'I was so short of breath I was unable to finish a sentence' 

A 23-year-old medic with Covid was treated at CUH after being hit by four days of vomiting, diarrhoea, dry cough, fever and a rash on his hands, feet, and buttocks

  

A medic who contracted Kawasaki-like hyperinflammatory syndrome, a rare condition associated with Covid-19, said he was aware he had respiratory and heart failure "and wondered would I get out alive".

The man's story is outlined in a new case study published by medics at Cork University Hospital, where the 23-year-old was treated after being hit by four days of vomiting, diarrhoea, dry cough, fever, and a rash on his hands, feet and buttocks.

Owen O'Flynn, otherwise fit and healthy with no background medical history and not on any regular medications, had been working at the hospital as a medical intern and is one of the co-authors of the report into what happened to him last year.

"Exposure history was notable for having worked on wards where patients with Covid-19 were being treated," the study outlined, adding that Mr O'Flynn, from Bantry, had first lost his sense of taste and smell five weeks beforehand, but did not have any other symptoms consistent with Covid-19. 

"He was unable to taste or smell his coffee following an on-call shift," it said.

According to the research paper: "At the time of this patient’s presentation in May 2020, no cases of this syndrome occurring in an adult had been published in the medical literature. However, given the unusual clinical presentation, coupled with the exposure history, there was a strong suspicion from the outset that this was a manifestation of Covid-19."

Depleted oxygen levels

The man was discharged on Day 13 and subsequently made a full recovery, but the paper shows how he had severely depleted oxygen levels that required respirator intervention, as well as severe rash and other medical difficulties.

While describing it as "a rare entity", the authors of the report, who also include Dr Corinna Sadlier and Dr Eamonn Faller of the Department of Infectious Diseases at CUH, said: "Presentation of this syndrome may be weeks after initial infection [with Covid-19]" and "Covid-19 is not always a benign entity in young adults and may cause critical illness".

Dr Sadlier said she understood the case was the first of its kind in Ireland, although others have occurred since.

The paper also included the patient's perspective. In it, Mr O'Flynn said: "My Covid-19 story starts in late March when I experienced a loss of taste and smell. I had no other symptoms at the time and so did not qualify for a test at the time. About a month later, the day after working a shift in my hospital’s Covid-19 intensive care unit (ICU), 

I began to feel unwell. It seemed at the time like a gastroenteritis with an unusual rash but eventually was so severe that I needed to be admitted to hospital.

"In the evening, I deteriorated. I can remember a point where it seemed that in the space of a minute I went from feeling okay to being so short of breath that I was unable to finish a sentence. The days after being admitted to ICU were extremely worrying for me. I was aware I had respiratory and heart failure and wondered would I get out alive. I was in constant contact with my girlfriend and family and got great emotional support from the staff and my friends.

"Thankfully, things did begin to resolve but when I got home I was by no means fixed. I was still breathless walking around and it really took 6 weeks to feel like myself again. While the elderly are most at risk, I am a fit and well 23-year old and still ended up in ICU with Covid-19."