Post-COVID Pulmonary Aspergillosis with Pulmonary Thromboembolism and Pulmonary Artery Hypertension Unmasking Prediabetes: A Case Report

Abstract

Multiple complications during and following COVID-19 infection are being reported worldwide. The most serious and life-threatening are thromboembolism and invasive fungal diseases. We report a post-COVID-19 case with complications of fungal infection of the lungs and pulmonary thromboembolism with pulmonary hypertension and unmasking prediabetes. A 53-year-old male patient presented with complaints of cough, fever, exertional breathlessness for 15 days, chest pain and hoarseness of voice for 7 days. He had a prior history of COVID 10 months earlier and no comorbidities. On further investigation by computed pulmonary tomography angiography, bronchoscopy and other investigations, the patient was found to have pulmonary thromboembolism, pulmonary aspergillosis and pulmonary artery hypertension. He was treated with amphotericin B for 21 days and anticoagulants for 6 months. He had significant clinical and radiological improvement with the resolution of the embolism. The crucial factors for successful care in post-COVID-19 immune-suppressed patients include a high index of suspicion, early use of adequate diagnostic tests helped by antifungal medications, anticoagulants and control of risk factors such as hyperglycaemia.