2020
DOI: 10.1093/ehjcr/ytaa448
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Systemic thrombolysis and anticoagulation improved biomarker measurements in massive-like pulmonary embolism and severe COVID-19 pneumonia: a case report

Abstract: Background From asymptomatic patients to severe acute respiratory distress syndrome, COVID-19 has a wide range of clinical presentations, and venous thromboembolism has emerged as a critical and frequent complication. Case summary We present a case of a 69-year-old man with a clinical presentation of massive-like pulmonary embolism (PE) overlapping with severe COVID-19 pneumonia. The diagnosis was made based on hypotension, s… Show more

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Cited by 4 publications
(3 citation statements)
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“…Emerging evidence suggests that COVID-19 is characterized by endothelitis secondary to direct viral infection facilitated by the overexpression of angiotensin-converting enzyme receptor 2, the receptor for cell entry of SARS-CoV-2 in endothelial cells, highly expressed in the lungs, heart, veins, and arteries. 18 , 27 , 28 SARS-CoV-2 in most patients causes a high prothrombotic state inducing thrombosis through inflammation pathways, endothelial activation, immunothrombosis, 29 cytokine storm, 30 and coagulation system activation. Dysregulation of the renin-angiotensin system and the innate and adaptive immune system also plays an essential role.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Emerging evidence suggests that COVID-19 is characterized by endothelitis secondary to direct viral infection facilitated by the overexpression of angiotensin-converting enzyme receptor 2, the receptor for cell entry of SARS-CoV-2 in endothelial cells, highly expressed in the lungs, heart, veins, and arteries. 18 , 27 , 28 SARS-CoV-2 in most patients causes a high prothrombotic state inducing thrombosis through inflammation pathways, endothelial activation, immunothrombosis, 29 cytokine storm, 30 and coagulation system activation. Dysregulation of the renin-angiotensin system and the innate and adaptive immune system also plays an essential role.…”
Section: Discussionmentioning
confidence: 99%
“…Dysregulation of the renin-angiotensin system and the innate and adaptive immune system also plays an essential role. 30,31 All these mechanisms associated with in-hospital and ICU risk factors 30 explain the high incidence of venous thromboembolism. [8][9][10]17,31 SARS-COV-2 inflammation can destabilize a vulnerable plaque 32 in the elderly with ischemic heart disease and subclinical atherosclerosis.…”
Section: Discussionmentioning
confidence: 99%
“…The patients were diagnosed with COVID-19, ADRS, and PE, and thrombolytic therapy was successfully performed in all of them [ 52 ]. Betancourt-Del Campo et al [ 53 ] presented a case of a 69-year-old man with severe COVID-19, respiratory failure, and acute right ventricular insufficiency who was successfully treated with alteplase. Aguilar-Piedras et al [ 54 ] presented an interesting case of a 53-year-old multimorbid patient with COVID-19, who rapidly deteriorated due to pneumothorax and PE and was successfully treated with a half-dose of alteplase.…”
Section: Discussionmentioning
confidence: 99%