A case-report of widespread pulmonary embolism in a middle-aged male seven weeks after asymptomatic suspected COVID 19 i
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CASE REPORT
Open Access
A case-report of widespread pulmonary embolism in a middle-aged male seven weeks after asymptomatic suspected COVID 19 infection Mats Beckman1,2, Sven Nyrén1,2 and Anna Kistner2,3*
Abstract Background: Pulmonary embolism (PE) is seen in high frequency in hospital-treated patients with Covid-19. We present a case of suspected Covid-19 with long-term dyspnea and widespread PE. Case presentation: A 51- year old male, with no prior medical history, no medication, and non-smoker arrived at the emergency department with exercise induced dyspnea during 4–5 weeks and for the last 48 h dyspnea at rest. Seven weeks before hospitalization, he felt difficulties taking deep breaths for some days but no other symptoms. Oxygen saturation at rest was 93%. Troponin T was 1200 mg/L (ref < 15 mg/L). CT angiography revealed widespread bilateral segmental pulmonary embolism. Additional findings were ground glass opacities that could match Covid-19. The patient tested negative for SARS -CoV-2. Full dose tinzaparin was given for 2 days in hospital, followed by apixaban for 6 months. Recovery has been uneventful so far. Conclusions: Long-term breathing difficulties might be relatively common after non-hospitalized symptomatic Covid-19. The frequency of PE in this group is unknown. We report a case of suspected covid-19 with widespread PE and a long history of dyspnea but no other symptoms. In our case slight hypoxia and laboratory testing indicated significant disease, which was proven with contrast angiography. This case shows that PE is a differential diagnosis in non-hospitalized symptomatic Covid-19 with persisting breathing problems. Keywords: Pulmonary embolism, Covid-19, Male, Ground-glass
Background Pulmonary embolism (PE) has been shown to be common in hospitalized Covid-19 patients with a 30% incidence [1]. In Sweden, infected subjects treated at home were not tested. Falling ill with fever and cough were regarded as typical Covid-19 infection and the recommendations from the Public Health Authority (FHM) in * Correspondence: [email protected] 2 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden 3 Medical Radiation Physics and Nuclear Medicine, Imaging and Physiology, Karolinska University Hospital, Stockholm, Sweden Full list of author information is available at the end of the article
Sweden was “stay at home until you feel healthy and 48 hours thereafter” [2]. We report a case of suspected Covid-19 infection with widespread pulmonary embolism in a patient with no previous symptoms and severe pulmonary embolism.
Case presentation A 51- year old male, with no prior medical history, no medication, non-smoker and without risk factors for venous thrombo-embolism arrived at the end of April to the emergency department with exercise induced dyspnea during 4–5 weeks and for the last 48 h
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