Coronavirus 19 disease (COVID-19) presents a highly variable clinical presentation and course, ranging from asymptomatic patients to rapidly progressive, fatal pneumonia. The known heterogeneous outcomes can affect both previously healthy patients and those with significant comorbidities, who develop clinical courses with possibly more multisystemic compromise. Likewise, the development of thrombotic phenomena during the acute course of the disease is associated with complications that worsen patient prognosis. We present a case report of a 45-year-old multiparous patient with a history of overweight and chronic use of oral hormonal contraception with low doses of levonorgestrel and estradiol as the only risk factors favoring the development of thrombotic events. During her outpatient COVID-19 clinical course, she developed massive pulmonary thromboembolism resulting in secondary obstructive shock, which required pharmacological thrombolysis. At discharge, hormonal contraception was considered contraindicated, and the patient was released from our institution with continued oral anticoagulant therapy. COVID-19 infection, contraceptive hormone therapy, and overweight are known risk factors for the development of thromboembolic events. The impact of their concomitance has not been studied to date. From our experience, we discuss the impact these risk factors have when present together and invite others to report similar cases.

La aparición de cepas de enterococcus resistentes a daptomicina es un tema de preocupación clínica y epidemiológica en años recientes. A continuación, se presenta el caso de paciente de 50 años con antecedente de artritis reumatoide e inmunosupresión crónica hospitalizado en contexto de neumonía viral por COVID-19, con sobreinfección bacteriana y choque séptico en varias ocasiones con aislamientos múltiples, en quien se documentaron en 3 oportunidades diferentes aislamientos de enterococcus faecium vancomicino-resistente VAN A Y B con falla terapéutica a Daptomicina, por deterioro clínico y persistencia de hemocultivos positivos. Se inició manejo con linezolid logrando modulación de infección, negativización de hemocultivos y evolución clínica satisfactoria del paciente. Se realiza reporte de caso presentado en hospital de Bogotá, para dar a conocer la presencia de enterococos resistentes a daptomicina, la cual es una creciente preocupación epidemiológica, con el fin de prevenir falla terapéutica, realizar identificación temprana y conocer epidemiología local.