RESUMEN
Although COVID-19 coagulopathy typically manifests with thrombotic complications, hemorrhagic complications also occur and must be considered when making decisions about anticoagulation in these patients. Here, we report a case of massive hemoptysis occurring in a recently post-partum woman via Cesarean section with COVID-19 who was managed via bronchial artery embolization while on extracorporeal membrane oxygenation.
Asunto(s)
COVID-19 , Embolización Terapéutica , Oxigenación por Membrana Extracorpórea , Arterias Bronquiales/diagnóstico por imagen , Cesárea/efectos adversos , Embolización Terapéutica/efectos adversos , Oxigenación por Membrana Extracorpórea/efectos adversos , Femenino , Hemoptisis/diagnóstico por imagen , Hemoptisis/etiología , Hemoptisis/terapia , Humanos , Periodo Posparto , Embarazo , SARS-CoV-2RESUMEN
Coronavirus disease 2019 (COVID-19) is a novel infectious disease affecting the general population worldwide. A fever and cough are the common clinical presentations of COVID-19. In most of these patients, computed tomography (CT) shows bilateral peripheral ground-glass opacities. We herein report a case of hemoptysis and lung bulla in the convalescent phase of COVID-19. Based on the clinical observations, alveolar destruction was likely associated with hemoptysis and bulla formation. Therefore, we suggest the follow-up of COVID-19 patients whose clinical parameters indicate alveolar damage, even after their symptoms improve.
Asunto(s)
Vesícula/etiología , COVID-19/complicaciones , COVID-19/patología , Hemoptisis/etiología , Pulmón/patología , Vesícula/diagnóstico por imagen , Vesícula/patología , COVID-19/diagnóstico por imagen , Tos/virología , Fiebre/virología , Hemoptisis/diagnóstico por imagen , Hemoptisis/patología , Humanos , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Alveolos Pulmonares/diagnóstico por imagen , Alveolos Pulmonares/patología , SARS-CoV-2 , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing pandemic that profoundly challenges healthcare systems all over the world. Fever, cough and fatigue are the most commonly reported clinical symptoms. CASE PRESENTATION: A 58-year-old man presented at the emergency department with acute onset haemoptysis. On the fifth day after admission, he developed massive haemoptysis. Computed tomography (CT) angiography of the chest revealed alveolar haemorrhage, more prominent in the left lung. Flexible bronchoscopy confirmed bleeding from the left upper lobe, confirmed by a bronchial arteriography, which was successfully embolized. Nasopharyngeal swabs (NPS) tested for SARS-CoV-2 using real-time polymerase chain reaction (RT-PCR) repeatedly returned negative. Surprisingly, SARS-CoV-2 was eventually detected in bronchoalveolar lavage (BAL) fluid. CONCLUSIONS: Life-threatening haemoptysis is an unusual presentation of COVID-19, reflecting alveolar bleeding as a rare but possible complication. This case emphasises the added value of bronchoscopy with BAL in the diagnostic work-up in case of high clinical suspicion and negative serial NPS in patients presenting with severe symptoms.