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Currently, there are no approved specific antiviral agents for novel coronavirus disease 2019 (COVID-19). Convalescent plasma has not yet been approved for use in patients with COVID-19 infection; however, it is regulated as an investigational product. This is a case report of a 55-year-old male, with COVID-19 pneumonia who has received convalescent plasma as part of a treatment plan which showed significant radiological and clinical improvement post-treatment.

COVID-19 has been an ever-evolving viral pandemic which can cause systemic disturbance especially in some of the critically ill patients. Neurologic or Neuro-imaging manifestations of COVID-19 are being increasingly reported in these patients and mainly consist of ischemic strokes, hypoxic ischemic injury and non-specific encephalopathy. Ischemic strokes as expected more commonly afflict major vascular territories, likely due to accentuated hypercoagulability in these patients. Certain vascular territories may be more susceptible to ischemic infarcts. We observed higher predilection for infarcts in posterior inferior cerebellar artery (PICA). This may represent another peculiarity of this pandemic.

Purpose. Our aim is to identify the prevalence and distribution of pulmonary thromboembolism in COVID-19 infected patients in our hospital. Materials and Methods. Data of all patients with COVID-19 infection either on RT-PCR testing or non-contrast high resolution CT(HRCT) who had CT pulmonary angiography (CTPA) from April to June 2020 were included. 133 patients were initially included in the study, 7 were excluded according to exclusion criteria, leaving a total number of 126 patients. Results. Twenty (15.8%) patients had evidence of pulmonary embolism (PE) on CTPA with mean age of 50 years (range 31-85) of which 95% were males. The mean D-dimer was 5.61mcg/mL among the PE-negative and 14.49 mcg/mL in the PE-positive groups respectively. Among the patients with evidence of pulmonary embolism on CTP, almost half required admission to intensive care unit in comparison to only one-fifth with negative CTPA. One-fourth died among the PE positive group with only 5% died among the PE negative group. There was a 33% reduction in the development of PE in the COVID-19 patients who had received low molecular weight heparin (LMWH) prior to their CTPA study versus those who had not. Conclusion. D-dimer correlates well with the incidence of pulmonary embolism among COVID-19 patients. Our data suggest that majority of our patients, developed pulmonary embolisms within 5 days into their hospital stay, accounting to almost two thirds of all positive cases diagnosed by CTPA. Those with PE among COVID-19 patients have high chances of ICU admission and mortality. Use of thromboprophylaxis early on might reduce the incidence of PE.