Paradoxical embolism subsequently pneumonia from the 2019 coronavirus disease. A Case report
Keywords:
Coronavirus, Paradoxical embolism, Pulmonary embolism, Pneumonia.Abstract
In December 2019, the 2019 coronavirus disease, produced by the type 2 coronavirus causing severe acute respiratory syndrome, was identified for the first time. Increasingly investigations are reporting the occurrence of systemic complications, some of them in a mediate or even late phase of the disease, when the patient has left the hospital. A 30-year-old healthy female patient who came to the hospital fourteen days after being discharged due to viral pneumonia secondary to SARS-COV-2. She presented with intense pain and distal coldness in the right lower limb, dyspnea at rest and pain in the left hypochondrium. The diagnosis at discharge was paradoxical pulmonary thromboembolism. Thrombotic complications should be taken into account in all convalescent COVID-19 patients. An early diagnosis is important to establish anticoagulation.
References
Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle. J Med Virol. [Internet]. 2020 [citado 7/04/2021]; 92(4):401–402. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31950516/
Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MNg, Fan E, et al. Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Crit Care Med. [Internet].2020 [citado 7/04/2021]; 46(5):854-887. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32222812/
Ashraf O, Young M, Malik KJ, Cheema T. Systemic Complications of COVID-19. Critical Care Nursing Quarterly. [Internet]. 2020 [citado 7/04/2021]; 43(4):390-399. Disponible en: https://covid19.elsevierpure.com/en/publications/systemic-complications-of-covid-19
Martínez Chamorro E, Revilla Ostolaza TY, Pérez Núñez M, Borruel Nacenta S, Conde Rodríguez-Guerra C, Ibáñez Sanz L. Tromboembolismo pulmonar en pacientes con COVID-19: estudio de prevalencia en un hospital terciario. Radiología. [Internet]. 2021 [citado 7/04/2021]; 63(1):13-21. Disponible en: https://www.sciencedirect.com/science/article/pii/S0033833820301405
Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19.Thromb Res. [Internet]. 2020 [citado 7/04/2021]; 191(1):145–147. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146714/
Capilla Montes MT, Gómez Caravaca J, Fernández Catalán C, Landaluce Chaves M, Mira Sirvent, Masegosa Medina JA. Embolismo paradójico: ¿una entidad infrecuente o poco diagnosticada? Angiología. [Internet]. 2007 [citado 7/04/2021]; 59(6):451-456. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0003317007750824
Pons Pellicé L, Camio Visauta E, Chocron Da Prat I, Rodríguez Palomares JF, Rosés Noguer F, de Nadal M. Ictus de la arteria cerebral media por embolia paradójica en paciente con neumonía por COVID-19. Rev Española de Cardiología. [Internet]. 2021 [citado 7/04/2021]; 74(6):558-559. Disponible en: https://www.revespcardiol.org/es-ictus-arteria-cerebral-media-por-articulo-S0300893220307041
Yu Z, Shanea Estes K, Ramadan Ali A, Alex Gandhi A, Srilakshmi Yalavarthi, Hui Shi, et al. Prothrombotic autoantibodies in serum from patients hospitalized with COVID-19. Science Translational Medicine. [Internet]. 2020 [citado 7/04/2021]; 12(570):eabd3876. Disponible en: https://stm.sciencemag.org/content/12/570/eabd3876
Puzzitiello RN, Pagani NR, Moverman MA, Moon AS, Menendez MA, Ryan SP. Inflammatory and coagulative considerations for the management of orthopaedic trauma patients with covid-19: a review of the current evidence and our surgical experience. Journal of Orthop Trauma. [Internet]. 2020 [citado 7/04/2021]; 34(8):389-394. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302072/
Rogani S, Calsolaro V, Franchi R, Calabrese AM, Okoye C, Monzani F. Spontaneous muscle hematoma in older patients with COVID-19: two case reports and literature review. BMC Geriatr. [Internet]. 2020 [citado 7/04/2021]; 20(539):[aprox. 14 p.]. Disponible en: https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-020-01963-4
Tabibkhooei A, Hatam J, Mokhtari M, Abolmaali M. COVID-19-associated spontaneous subacute subdural haematoma: report of two cases. New Microbes and New Infections. [Internet]. 2021 [citado 7/04/2021]; 40(1):[aprox. 4 p.]. Disponible en: https://www.sciencedirect.com/science/article/pii/S2052297521000123
Mazzitelli M, Serapide F, Tassone F, Laganà D, Trecarichi EM, TortiC. Spontaneous and Severe Haematomas in Patients with COVID-19 on Low- Molecular-Weight Heparin for Paroxysmal Atrial Fibrillation. Mediterr J Hematol Infect Dis. [Internet]. 2020 [citado 7/04/2021]; 12(1):e2020054. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340243/
Paranjpe I, Fuster V, Lala A, Russak A, Glicksberg BS, Levin MA, et al. Association of Treatment Dose Anticoagulation with In-Hospital Survival among Hospitalized Patients with COVID-19. J Am Coll Cardiol. [Internet]. 2020 [citado 7/04/2021]; 76(1):122–124. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202841/
Jiménez Soto R, Montiel Romero S, Neme Yunes Y, Demichelis Gómez MR, Inclán Alarcón SI. Estrategias de anticoagulación en pacientes con COVID-19. Rev Hematol Mex. [Internet]. 2020 [citado 7/04/2021]; 21(4):210-224. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=97014
Loscalzo J. Paradoxical embolism: clinical presentation, diagnostic strategies, and therapeutic options. Am Heart J. [Internet]. 1986 [citado 7/04/2021]; 112(1):141-5. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/0002870386906927
Ballvé Martín A, Boned S, Rubiera M. Complicación trombótica de neumonía grave por COVID-19, ictus por embolismo paradójico atípico. Rev. deneurol. [Internet]. 2020 [citado 7/04/2021]; 71(5):186-190. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=7556548
Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MNg, Fan E, et al. Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Crit Care Med. [Internet].2020 [citado 7/04/2021]; 46(5):854-887. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32222812/
Ashraf O, Young M, Malik KJ, Cheema T. Systemic Complications of COVID-19. Critical Care Nursing Quarterly. [Internet]. 2020 [citado 7/04/2021]; 43(4):390-399. Disponible en: https://covid19.elsevierpure.com/en/publications/systemic-complications-of-covid-19
Martínez Chamorro E, Revilla Ostolaza TY, Pérez Núñez M, Borruel Nacenta S, Conde Rodríguez-Guerra C, Ibáñez Sanz L. Tromboembolismo pulmonar en pacientes con COVID-19: estudio de prevalencia en un hospital terciario. Radiología. [Internet]. 2021 [citado 7/04/2021]; 63(1):13-21. Disponible en: https://www.sciencedirect.com/science/article/pii/S0033833820301405
Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19.Thromb Res. [Internet]. 2020 [citado 7/04/2021]; 191(1):145–147. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146714/
Capilla Montes MT, Gómez Caravaca J, Fernández Catalán C, Landaluce Chaves M, Mira Sirvent, Masegosa Medina JA. Embolismo paradójico: ¿una entidad infrecuente o poco diagnosticada? Angiología. [Internet]. 2007 [citado 7/04/2021]; 59(6):451-456. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0003317007750824
Pons Pellicé L, Camio Visauta E, Chocron Da Prat I, Rodríguez Palomares JF, Rosés Noguer F, de Nadal M. Ictus de la arteria cerebral media por embolia paradójica en paciente con neumonía por COVID-19. Rev Española de Cardiología. [Internet]. 2021 [citado 7/04/2021]; 74(6):558-559. Disponible en: https://www.revespcardiol.org/es-ictus-arteria-cerebral-media-por-articulo-S0300893220307041
Yu Z, Shanea Estes K, Ramadan Ali A, Alex Gandhi A, Srilakshmi Yalavarthi, Hui Shi, et al. Prothrombotic autoantibodies in serum from patients hospitalized with COVID-19. Science Translational Medicine. [Internet]. 2020 [citado 7/04/2021]; 12(570):eabd3876. Disponible en: https://stm.sciencemag.org/content/12/570/eabd3876
Puzzitiello RN, Pagani NR, Moverman MA, Moon AS, Menendez MA, Ryan SP. Inflammatory and coagulative considerations for the management of orthopaedic trauma patients with covid-19: a review of the current evidence and our surgical experience. Journal of Orthop Trauma. [Internet]. 2020 [citado 7/04/2021]; 34(8):389-394. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302072/
Rogani S, Calsolaro V, Franchi R, Calabrese AM, Okoye C, Monzani F. Spontaneous muscle hematoma in older patients with COVID-19: two case reports and literature review. BMC Geriatr. [Internet]. 2020 [citado 7/04/2021]; 20(539):[aprox. 14 p.]. Disponible en: https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-020-01963-4
Tabibkhooei A, Hatam J, Mokhtari M, Abolmaali M. COVID-19-associated spontaneous subacute subdural haematoma: report of two cases. New Microbes and New Infections. [Internet]. 2021 [citado 7/04/2021]; 40(1):[aprox. 4 p.]. Disponible en: https://www.sciencedirect.com/science/article/pii/S2052297521000123
Mazzitelli M, Serapide F, Tassone F, Laganà D, Trecarichi EM, TortiC. Spontaneous and Severe Haematomas in Patients with COVID-19 on Low- Molecular-Weight Heparin for Paroxysmal Atrial Fibrillation. Mediterr J Hematol Infect Dis. [Internet]. 2020 [citado 7/04/2021]; 12(1):e2020054. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340243/
Paranjpe I, Fuster V, Lala A, Russak A, Glicksberg BS, Levin MA, et al. Association of Treatment Dose Anticoagulation with In-Hospital Survival among Hospitalized Patients with COVID-19. J Am Coll Cardiol. [Internet]. 2020 [citado 7/04/2021]; 76(1):122–124. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202841/
Jiménez Soto R, Montiel Romero S, Neme Yunes Y, Demichelis Gómez MR, Inclán Alarcón SI. Estrategias de anticoagulación en pacientes con COVID-19. Rev Hematol Mex. [Internet]. 2020 [citado 7/04/2021]; 21(4):210-224. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=97014
Loscalzo J. Paradoxical embolism: clinical presentation, diagnostic strategies, and therapeutic options. Am Heart J. [Internet]. 1986 [citado 7/04/2021]; 112(1):141-5. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/0002870386906927
Ballvé Martín A, Boned S, Rubiera M. Complicación trombótica de neumonía grave por COVID-19, ictus por embolismo paradójico atípico. Rev. deneurol. [Internet]. 2020 [citado 7/04/2021]; 71(5):186-190. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=7556548
Downloads
Published
2021-07-16
How to Cite
1.
Belaunde Clausell A, Romero Reinaldo Y, Díaz Fonseca J. Paradoxical embolism subsequently pneumonia from the 2019 coronavirus disease. A Case report. Rev 16 de abril [Internet]. 2021 Jul. 16 [cited 2024 Dec. 12];60(281):e1308. Available from: https://rev16deabril.sld.cu/index.php/16_04/article/view/1308
Issue
Section
Case Report
License
Those authors who have publications with this journal, accept the following terms:
The authors will retain their copyright and guarantee the journal the right of first publication of your work, which will be under a Creative license Commons Attribution-NonCommercial-ShareAlike 4.0 International . (CC BY-NC-SA 4.0).
The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (eg:deposit it in an institutional telemat
