Stroke and pulmonary embolism in moderate CoViD-19
Italian Journal of Medicine
; 15(3):12, 2021.
Article
in English
| EMBASE | ID: covidwho-1567335
ABSTRACT
Background:
Venous thromboembolism, arterial thrombosis and thrombotic microangiopathy substantially contribute to increased morbidity and mortality in CoViD-19. We report a case of 56-year old man that presented with stroke and was found to have CoViD- 19 pneumonia complicated by pulmonary embolism (PE). Description of the case A 55-year-old man with history of hypertension presented to the emergency department after a transient loss of consciousness. He was found to have left lateral hemianopia and lower right quadrantanopsia and head CT confirmed bilateral stroke in the posterior cerebral artery territory. MR angiography excluded atherosclerosis/dissection of the vertebral and basilar artery and a positive nasopharingeal swab PCR test revealed SARS-CoV-2 infection. The patient was admitted and ASA 100 mg and enoxaparin 40 mg per day were started. He experienced dry cough and fever and 10 days after admission presented atypical chest pain. CT Angiography revealed multiple confined ground glass opacities with segmental bilateral PE. Therapeutic dose of enoxaparin was started and after 5 days switched to edoxaban 60 mg per day. The patient progressively recovered and a complete work up excluded patent foramen ovale and any other cause predisponing to combined presence of venous and arterial thrombosisConclusions:
CoViD-19 has presented many diagnostic challanges in patients with neurologic and respiratoryfindings:
thromboembolic disease may even be the initial or unique presentation. The early recognition of these phenotipes of the disease play a dramatic role in the CoViD-19 management.
edoxaban; enoxaparin; adult; artery, dissection; artery, thrombosis; atherosclerosis; basilar, artery; case, report; cerebral, artery, disease; cerebrovascular, accident; clinical, article; complication; computed, tomographic, angiography; conference, abstract; coronavirus, disease, 2019; drug, therapy; dry, cough; emergency, ward; fever; ground, glass, opacity; hemianopia; human; hypertension; lung, embolism; magnetic, resonance, angiography; male; middle, aged; patent, foramen, ovale; polymerase, chain, reaction; surgery; therapeutic, dose; thorax, pain; unconsciousness; vein, thrombosis
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Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Italian Journal of Medicine
Year:
2021
Document Type:
Article
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