COVID-19 Pneumonia Complicated by Pneumomediastinum: A Case Report

Cardoso, João Luís; Castro, Ivo; Gaspar, Vasco; Esteves, Cristina L.

doi:10.7759/cureus.32508

Cited by 1 publication

(1 citation statement)

References 7 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present case, the patient was admitted at the end of 2020, to a secondary hospital in Portugal, at the peak second wave of COVID-19. The available resources were scarce, both human and material resources (echocardiogram was not usually available outside working hours, and its use on COVID-19 patients was very limited; hemodialysis was also not available for COVID-19 patients), and supply shortages of medical resources were even more exacerbated by disruptions to the global supply chain [ 20 , 21 ]. Nevertheless, reviewing the case, this patient should have had a contrast CT at admission.…”

Section: Discussionmentioning

confidence: 99%

Right Ventricle Thrombus in a Massive Pulmonary Embolism COVID-19 Patient

Gaspar,

Silva,

Ambrioso

et al. 2023

Cureus

Self Cite

View full text Add to dashboard Cite

The coronavirus disease 2019 (COVID-19) infection presents with a wild range of clinical manifestations. Increased inflammatory response and thrombotic risk have been described, being pulmonary embolism a potential cause of death in these patients. Pulmonary embolisms with right ventricle thrombus are rare and have higher mortality rates. This case report concerns a rare clinical presentation of a 75-year-old male with a medical history of right renal transplantation 36 years ago, that presented with a ten-day history of asthenia, followed by fever, shortness of breath, and cough since the day before. He was admitted with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pneumonia and respiratory insufficiency. The next morning the patient worsened, he presented with hypotension, tachycardia, severe refractory hypoxemia, and chest pain. Contrast CT showed a massive pulmonary embolism with a right ventricle thrombus, confirmed by an echocardiogram. Anticoagulation and IV fluids were started, and the patient was transferred to the ICU. He developed obstructive shock, so thrombolysis was performed with a full dose of alteplase. The outcome was good with complete recovery. Posterior investigation excluded other causes for pulmonary embolism. The severity of pulmonary parenchymal disease secondary to COVID-19 correlates with thromboembolic complications, which demand a swift response to avoid death. An abrupt deterioration in oxygenation should raise suspicion for PE in COVID-19 patients, and mostly in the presence of hypotension and tachycardia. In our case report, there was a massive pulmonary embolism with a rare right ventricle thrombus that had a good outcome with medical treatment.

show abstract

Section: Discussionmentioning

confidence: 99%