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Recurrent massive pulmonary embolism following catheter directed thrombolysis in a 21-year-old with COVID-19: a case report.
Hirschbaum, Julian H; Bradley, C Pierce; Kingsford, Philip; Mehra, Anilkumar; Kwan, Wilson.
  • Hirschbaum JH; Department of Pediatrics, Keck School of Medicine of USC, LAC+USC Med+Peds, IRD Building 2020 Zonal Avenue, Rm 115, Los Angeles, CA 90033, USA.
  • Bradley CP; Department of Internal Medicine, Keck School of Medicine of USC, 2020 Zonal Avenue, IRD 620, Los Angeles, CA 90033, USA.
  • Kingsford P; Department of Internal Medicine, Keck School of Medicine of USC, 2020 Zonal Avenue, IRD 620, Los Angeles, CA 90033, USA.
  • Mehra A; Department of Internal Medicine, Keck School of Medicine of USC, 2020 Zonal Avenue, IRD 620, Los Angeles, CA 90033, USA.
  • Kwan W; Department of Cardiology, Keck School of Medicine of USC, Division of Cardiovascular Medicine, 1510 San Pablo Street, Suite 322, Los Angeles, CA 90033, USA.
Eur Heart J Case Rep ; 5(4): ytab140, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1315695
ABSTRACT

BACKGROUND:

Coronavirus Disease-2019 (COVID-19) has been associated with increased incidence of pulmonary embolism (PE), even among patients at low risk for venous thrombo-embolic (VTE) events. CASE

SUMMARY:

We present the case of a 21-year-old male, with no previous medical history, who presented with cough, fevers, shortness of breath, pleuritic chest pain, and 1 day of dizziness with near syncope as well as acutely worsened dyspnoea. He was subsequently diagnosed with COVID-19 and massive PE. He underwent successful catheter-directed thrombolysis (CDT), and his clinical status improved. One day following initial CDT, he developed acute respiratory failure and hypotension and was diagnosed with recurrent massive PE. He was treated with repeat CDT and extracorporeal membrane oxygenation (ECMO) to provide time for right ventricular recovery. The patient was able to be weaned off ECMO after 9 days and was eventually extubated and discharged to an acute rehabilitation facility.

DISCUSSION:

Beyond COVID-19, no hypercoagulable risk factors were identified despite thorough investigation. This case highlights the thrombogenic potential and morbid sequelae of SARS-CoV-2 infection, even in young patients. It also highlights the use of CDT and ECMO among patients with massive PE and COVID-19. To date, this is the youngest reported patient to develop massive PE in the setting of COVID-19.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Observational study / Prognostic study Topics: Long Covid Language: English Journal: Eur Heart J Case Rep Year: 2021 Document Type: Article Affiliation country: Ehjcr

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Observational study / Prognostic study Topics: Long Covid Language: English Journal: Eur Heart J Case Rep Year: 2021 Document Type: Article Affiliation country: Ehjcr