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BMJ Case Rep ; 13(11)2020 Nov 30.
Article in English | MEDLINE | ID: covidwho-949258

ABSTRACT

We report an unusual complication of COVID-19 infection in a 53-year-old Caucasian man. He presented with shortness of breath, fever and pleuritic chest pain. A CT pulmonary angiogram (CTPA) demonstrated acute bilateral pulmonary embolism and bilateral multifocal parenchymal ground glass change consistent with COVID-19 (SARS-CoV-2) infection. Right adrenal haemorrhage was suspected on the CTPA which was confirmed on triple-phase abdominal CT imaging. A short Synacthen test revealed normal adrenal function. He was treated initially with an intravenous heparin infusion, which was changed to apixaban with a planned outpatient review in 3 months' time. He made an uncomplicated recovery and was discharged. Follow-up imaging nearly 5 months later showed near complete resolution of the right adrenal haemorrhage with no CT evidence of an underlying adrenal lesion.


Subject(s)
Adrenal Gland Diseases , Adrenal Glands/diagnostic imaging , COVID-19 , Computed Tomography Angiography/methods , Hemorrhage , Heparin/administration & dosage , Pulmonary Embolism , Pyrazoles/administration & dosage , Pyridones/administration & dosage , Adrenal Cortex Function Tests/methods , Adrenal Gland Diseases/diagnosis , Adrenal Gland Diseases/etiology , Adrenal Gland Neoplasms/diagnosis , Antithrombins/administration & dosage , COVID-19/complications , COVID-19/diagnosis , COVID-19/physiopathology , COVID-19/therapy , Clinical Deterioration , Diagnosis, Differential , Hemorrhage/diagnosis , Hemorrhage/etiology , Humans , Male , Middle Aged , Pulmonary Embolism/diagnosis , Pulmonary Embolism/etiology , Pulmonary Embolism/physiopathology , Pulmonary Embolism/therapy , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Treatment Outcome
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