Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome which was declared a global pandemic in 2019 causing significant morbidities and mortalities. COVID-19 is a multi-systemic disease and is not primarily limited to the respiratory system. Thrombus formation is one of its distinct features. However, renal complications associated with COVID-19 are rarely reported in the literature due to limited occurrence and research. We report a rare case of right retroperitoneal hematoma in a COVID-19 patient. We report a 51-year-old male patient who was received at the emergency department (ED). The patient was positive for COVID-19 and had a Glasgow coma scale of 12/15. The patient was initially managed on IV anticoagulation due to cavernous sinus thrombosis and was placed on mechanical ventilation which helped him to improve. After two weeks, a sudden drop in hemoglobin was observed. CT scan of abdomen and pelvis showed the presence of a right retroperitoneal hematoma, and right renal artery non-occlusive filling defect. The patient was successfully managed with conservative treatment. Retroperitoneal hematoma although a rare occurrence in COVID-19 patient should be observed and monitored closely in case of bleeding or anemia, as early management and intervention is beneficial.

Introduction: COVID-19 infection was associated with many morbid conditions, one of which is venous thromboembolism; however, this is varied in incidence and clinical characteristics, with no known definite risk predictors.Aim: To identify the incidence, clinical characteristics, and risks and outcome of venous thromboembolism in COVID-19 patients.Methods: a retrospective cohort study comparing the recorded data for two groups of patients with confirmed COVID-19 infection and admitted to the ICU in 6 months duration.Results: the incidence of venous thromboembolism was 30%, where pulmonary embolism (PE) alone was the most frequent type (68.2%), followed by, DVT with PE (15.1%), DVT alone (12.1%), cavernous sinus thrombosis alone CST (3%) and the least frequency was CST with renal artery thrombi (1.5%). Smoking and malignancy were more frequent in VTE group with more statistically significant elevation of D dimer. the pulmonary embolism was lobar in the majority of our patients (69.6%), followed by segmental (17.9%), while the least frequency was for massive pulmonary embolism (12.5%).Conclusion: VTE is a common event in COVID-19 patients, where smoking and malignancy more frequent, D dimer is significantly elevated, and more morbidity and mortality in those patients.

Background: COVID-19 does not necessarily affect the respiratory system only and can cause life threatening systemic condition. I present a case of pulmonary hemorrhage and (ANCA) C vasculitis with type I respiratory failure as a presentation of COVID-19.Case presentation: 45-year-old Saudi lady with no history of chronic medical problems, non-smoker, no history of any drug intake, married with 3 off springs, presented to our ED with massive hemoptysis with severe shortness of breath. On arrival: Patient was conscious, oriented & pale, Hypoxic on Oxygen via face mask 15 L/min, No clubbing, No L.L. edema, No palpable L.Ns. Chest: B/L inspiratory fine crepitation. CXR: B/L mid & lower zone consolidations sparing the apices & the angles. Lab investigations done revealed her Hb was 5.2 gm/dl, with disturbed kidney functions (urea: 11, creatinine: 284) so patient received 2 units PRBCs urgently, then shifted to ICU isolation where Swab screen for COVID19 was taken. CT chest without contrast findings are likely suggestive of diffuse alveolar hemorrhage. After 12 hours: Patient became hypotensive BL/p 80/50 with disturbed level of consciousness so intubated and mechanically ventilated (MV).ECG and echo cardio done and showed: No abnormalities detected and the Swab result was positive for COVID19 so started levophed infusion with continuous renal replacement therapy and gave patient pulse steroid for 3 days then plasma pharesis for 5 days. After that, intravenous immune-globin was added With Caspofungin being added on and tigecycline i.v. The results of serology and immunology showed negative for HIV and hepatitis and other connective tissue diseases while (ANCA) C was highly positive. After 3 weeks: Patient still on MV, we gave patient anti-CD20. Patient condition was deteriorated and after 4 weeks: Patient arrested and died on MV. Conclusion:Has evidence of diffuse alveolar hemorrhage and vasculitis as a complication of COVID-19 with poor prognosis.