Roig-Marín N, Roig-Rico P, Calbo-Maiques J, Chiner-Vives E

Language: Spanish
References: 9
Page: 642-647
PDF size: 879.37 Kb.

ABSTRACT

Background: SARS-CoV-2 infection can be associated with a hypercoagulable condition, which increases the prevalence of thromboembolic processes and the risk of deep vein thrombosis and pulmonary thromboembolism.
Clinical case: An 82-year-old hypertensive woman admitted to the emergency department due to arthromyalgia, severe asthenia and cough, associated with minimal dyspnea on moderate efforts and an increase in the perimeter of the lower right limb of 3 days of evolution. Upon arrival at the emergency department, she presented tachycardia and tachypnea at rest. In the emergency department blood test showed a D-dimer elevation of 21,131 ng/mL. The chest X-ray showed patchy lung opacities, which was consistent with COVID-19. The CT angiography of the pulmonary arteries showed findings of bilateral pulmonary thromboembolism and COVID-19 pneumonia. A second PCR was positive for SARS-CoV-2. The patient was hospitalized for 8 days and showed improvement with the use of anticoagulant treatment, so it was decided to discharge her with home isolation.
Conclusions: Recently, cases of thromboembolism are being described in patients with coronavirus infection, but pulmonary thromboembolism occurred when patient was admitted to the intensive care unit or in prolonged stays, unlike our patient who initially presented bilateral pulmonary thromboembolism, which is rare. Other cases of postpartum pulmonary embolism and after hospitalization associated with COVID-19 have been described. Therefore, in a patient with COVID-19, special attention must be paid to thromboembolic complications.

REFERENCES

1. Uddin M, Mustafa F, Rizvi TA, Loney T, et al. SARS-CoV-2/ COVID-19: Viral genomics, epidemiology, vaccines, and therapeutic interventions. Viruses 2020; 12 (5). doi. 10.3390/v12050526.

2. Boland-Rodríguez E, Estrada-Jaime MA, Soto-Salazar LG. Singulto como síntoma inicial de infección por SARSCoV- 2. Med Int Méx 2020; 36 (5): 745-748. https://doi. org/10.24245/mim. v36i5.4380.

3. Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood 2020; 135 (23): 2033-2040. doi. https://doi.org/10.1182/ blood.2020006000.

4. Poissy J, Goutay J, Caplan M, Parmentier E, et al. Pulmonary embolism in patients with COVID-19. Circulation 2020; 142 (2): 184-186. doi. 10.1161/CIRCULATIONAHA.120.047430.

5. Klok F, Kruip M, van der Meer N, Arbous M, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thrombosis Research 2020; 191: 145-147. doi. 10.1016/j.thromres.2020.04.013.

6. Helms J, Tacquard C, Severac F, Leonard-Lorant I, et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Med 2020; 46 (6): 1089-1098. doi. 10.1007/s00134- 020-06062-x.

7. Sakr Y, Giovini M, Leone M, et al. Pulmonary embolism in patients with coronavirus disease-2019 (COVID-19) pneumonia: a narrative review. Ann Intensive Care 2020; 10: 124. https://doi.org/10.1186/s13613-020-00741-0.

8. Khodamoradi Z, Boogar S, Shirazi F, Kouhi P. COVID-19 and acute pulmonary embolism in postpartum patient. Emerging Infect Dis 2020; 26 (8): 1937-1939. https://dx.doi. org/10.3201/eid2608.201383.

9. Vechi H, Maia L, Alves M. Late acute pulmonary embolism after mild coronavirus disease 2019 (COVID-19): a case series. Revista do Instituto de Medicina Tropical de São Paulo 2020; 62: e63. https://doi.org/10.1590/s1678- 9946202062063.