Beuy Joob1, Viroj Wiwanitkit2. 1. Sanitation 1 Medical Academic Center, Bangkok, Thailand. Electronic address: beuyjoob@hotmail.com. 2. Dr DY Patil University, Pune, India.
Dear Editor, we found that the publication on “Abdominal and testicular pain: An atypical presentation of COVID-19” is very interesting [1]. Kim et al. noted that “HCW's need to be vigilant of atypical presentations of COVID-19 and consider full PPE for all patients as community spread increases [1].” In fact, atypical and uncommon clinical presentation of COVID-19 is possible and it is usually under recognized [2]. A main pitfall in clinical practice is under diagnosis of COVID-19patients with mild or no symptoms. The use of criteria for screening for risk patient might be useful for screening but it might also lead to problem of delayed diagnosis of pre-symptomatic VOID-19 cases. In our setting, Thailand, the second country that COVID-19 occurred [3], there are some cases that emergency medical personnel expose and get infection. The problem is due to the lack of appropriate protection since there is no risk history of the patient. Additionally, we would like to share public data from local Thai Center of Disease Control. One patient (0.039 %) from 2551 overall patients (data on 13th April 2020) firstly presented with trauma due to accident. This case was managed at emergency unit and further managed by surgery specialist. The COVID-19 was detected after the patient already got surgery. We might point that lack of risk history or disguising of information is the leading cause of the problem but we should not forget that it is a basic rule in medicine to follow universal precautions.