Abstract

The covid-19 pandemic has affected healthcare delivery all around the globe. Due to the overwhelming number of cases over a short time, the focus has shifted towards controlling the spread of the disease globally. Due to the huge impact of covid-19, a majority of differential diagnoses are overlooked while delivering care to patients with respiratory symptoms which can lead to more severe consequences eventually. This report represents the case of a 57 years old Caucasian male who presented at the clinic for a follow-up, ten days after being treated at the urgent care for an inconclusive diagnosis of covid-19. He presented at the clinic with complaints of severe shortness of breath and the oxygen saturation had dropped to 87% on room air after being discharged from the urgent care. On reviewing the records, the covid-19 test was inconclusive and the Chest X-ray was negative for findings suggestive of covid-19.  There was no significant improvement in symptoms after being treated for covid-19 at the urgent care. Pulmonary Function Tests, alpha-1 antitrypsin deficiency test, and sleep studies were ordered at the clinic based on the patient's complaints of shortness of breath, snoring, daytime hypersomnolence, weight gain, and tiredness over the past five months and a 40 years history of smoking. He tested positive for alpha-1 antitrypsin deficiency as well as diagnosed with severe Obstructive Sleep Apnea. These findings suggest that a high suspicion for other differentials is vital while delivering patient care during the covid-19 pandemic.