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Vol. 22. Issue 1.
Pages 52-55 (January - April 2021)
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Vol. 22. Issue 1.
Pages 52-55 (January - April 2021)
Case report
DOI: 10.1016/j.vacune.2021.01.006
Intractable airsickness associated with COVID-19: A case report
Mareo al volar irresoluble asociado a la infección por COVID-19: caso clínico
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H. Talebi Bezmin Abadia, A.T.B. Abadib, A.A. Farahanic, M. Darvishid,
Corresponding author
darvishi1349@gmail.com

Corresponding author.
a Aerospace and Sub-Aquatic Medical Faculty, Aja University of Medical Sciences, Tehran, Iran
b Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
c Department of Medical Pathology, Medical Faculty, Tehran University of Medical Sciences, Tehran, Iran
d Infectious Diseases and Tropical Medicine Research Center (IDTMRC), Aerospace and Sub-Aquatic Medical Faculty, Aja University of Medical Sciences, Tehran, Iran
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Table 1. Probable causes that must be ruled out before the airsickness diagnosis.
Table 2. USAF preventive airsickness protocol.
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Abstract

A 29-yr-old male Melicopter co-pilot with high flight hours in air transport missions of the patients with COVID-19 tested positive for his RT-PCR due to clinical suspicion. With the diagnosis of SARS-CoV-2, he was treated based on the national protocol and stayed in the home quarantine for two weeks. Having been released for flying, he faced nausea, vomiting, facial cold sweat and pallor, dizziness, and imbalance that eventually caused flying avoidance during the three first flights. He has never had a similar problem or any predisposing factors during his pilot's training and afterwards. All the probable reasons ruled out after a complete assessment. Following the diagnosis of moderate airsickness, he was abstained from flying and treated with different prevention and rehabilitation techniques. None of them had enough clinical efficacies, applying the United States Air Force Preventive Airsickness Protocol as the last choice. Despite the three separate consecutive therapeutic courses, no significant clinical improvement was observed, and could not return to fly, yet. That is the first reported case of intractable airsickness in a flight crew that may be associated with SARS-CoV-2 infection.

Keywords:
COVID-19
SARS-CoV-2
Intractable airsickness
Pilot
Aeromedical transportation
Resumen

Un varón de 29 años de edad, copiloto de helicóptero médico, con gran número de horas de vuelo en misiones de transporte aéreo de los pacientes de COVID-19, dio positivo en las pruebas rápidas de PCR, debido a sospecha clínica. Diagnosticándose SARS-CoV-2, fue tratado sobre la base del protocolo nacional, permaneciendo en cuarentena domiciliaria durante dos semanas. Habiendo sido eximido de volar, padeció náuseas, vómitos, sudores fríos y palidez facial, mareos y falta de equilibrio, que le abstuvieron de volar durante las primeras tres semanas. No había tenido nunca un problema similar ni factores predisponentes durante su formación como piloto, ni después de esta. Tras un reconocimiento completo se descartaron todas las causas probables. Al diagnosticarse mareo moderado al volar, se le recomendó que se abstuviera de viajar en avión, tratándosele con diferentes técnicas de prevención y rehabilitación. Ninguna de ellas tuvo eficacia clínica suficiente, aplicándose el protocolo para la prevención de mareo al volar de las Fuerzas Aéreas de los Estados Unidos como última elección. A pesar de realizar los tres cursos terapéuticos separados consecutivos no se observó una mejora clínica significativa, y no pudo volver a volar. Se trata del primer caso reportado de mareo al volar irresoluble en una tripulación de vuelo, que puede estar asociado a la infección por SARS-CoV-2.

Palabras clave:
COVID-19
SARS-CoV-2
Mareo al volar irresoluble
Piloto
Transporte aeromédico

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