COVID-19 disease is no longer alone: A case of severe COVID-19 pneumonia with pulmonary embolism and deep vein thrombosis

Abstract

Almost eight million people were affected by the novel coronavirus (COVID-19) disease outbreak until now. The understanding of the disease has not fully emerged, but recent studies showed that thromboembolic events are frequently seen in this unique patient group as a contributor to mortality. A 65-year-old female was admitted to the emergency department (ED) with shortness of breath and fever for three days. Physical examination was notable with tachypnea and right lower extremity edema. The bedside ultrasound evaluation showed right-sided non-compressible common femoral vein with thrombus, and her laboratory was remarkable with a high D-dimer value (39.4 μg/dl). Finally, the patient was sent to the radiology unit for pulmonary computed tomography angiography, revealing filling defects at the pulmonary arteries and parenchymal findings that are consistent with COVID-19 pneumonia and pulmonary embolism (PE). Here, we presented a case of venous thromboembolism without any risk factor but COVID-19 pneumonia. To the best of our knowledge, this is one of the first cases reported in the literature diagnosed as COVID-19 pneumonia simultaneously with PE and deep vein thrombosis in the ED. Eventually, physicians should be vigilant about the occult pathologies associated with the novel coronavirus infection.