Late onset pulmonary embolism in young male otherwise healthy COVID-19 patients

Abstract

SARS-CoV-2 infection is associated with increased risk of thrombosis in severely ill patients but little is known about the risk in outpatients with mild to moderate disease. Our case series consists of four male otherwise healthy patients between 32 and 50 years of age. Initial symptoms completely resolved but they developed new onset of dyspnea and thoracic pain at days 14 to 26. CT scan revealed pulmonary embolism in all patients which led to hospitalization. Standard anticoagulation practice needs to be re-evaluated and may be considered for certain outpatients with COVID-19.

Pulmonary Embolism Associated with COVID-19 Occurs in Predominantly Elderly Patients with Comorbidities: A Single Center Retrospective Study

“…However, in our study in three patients, PE occurred after being discharged from hospital, felt well for a short time and some of them even did not have any inflammatory consolidations visible at the time of CTPA scanning. The similar observation was published, to our knowledge, just in one case-study ( Karolyi et al, 2021 ). The finding of COVID-19 negativization and an occurrence of thrombotic events is confronting current research results showing high PE incidence in seriously ill patients with COVID-19 pneumonia in critical care units ( Grillet, 2020 ; Leonard-Lorant et al, 2020 ; Middeldorp et al, 2020 ) and it warrants further investigation.…”

“…Radiologists noticed high incidence rate of the pulmonary embolism (PE), even despite thromboprophylaxis given. So far, there are several published case reports ( Brüggemann et al, 2020 ; Cellina & Oliva, 2020 ; Jafari et al, 2020 ) and researches ( Espallargas et al, 2021 ; Grillet, 2020 ; Karolyi et al, 2021 ; Leonard-Lorant et al, 2020 ; Lodigiani et al, 2020 ; Planquette et al, 2021 ) addressing the PE in a setting of COVID-19 infection. Literature showed the thrombotic complications occurred most often in seriously ill individuals ( Middeldorp et al, 2020 ) even without risk factors and in some cases even despite the given thromboprophylaxis.…”

Forty-One-Year-Old Man with Pulmonary Embolism 5 Months After COVID-19

“…To our knowledge, only few cases of venous thromboembolism reported late after COVID-19 onset. 7-11 However, our case is the first to report venous thromboembolism beyond the first 3 months of COVID-19 hospitalization or onset. These cases raise the following questions: Is COVID-19 an independent long-term risk factor for venous thromboembolism?…”

Home isolation, monitoring and follow-up as a management approach for mild to moderate COVID-19: a prospective observational study

“…Lower threshold for elevated D-dimer values and monitoring during the follow-up period can guide treatment for thromboprophylaxis in outpatient setup, probably preventing events like pulmonary embolism. 31 Dexamethasone was prescribed for 56 of 93 (60.2%) moderate group in the present study. One of these 56 patients needed hospitalization.…”