Pulmonary embolism: A complication of COVID 19 infection

• Published in: Thrombosis research Vol. 193; pp. 79 - 82
• Main Authors: Akel, Tamer, Qaqa, Firas, Abuarqoub, Ahmad, Shamoon, Fayez
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01-09-2020
• Subjects: Adult; Aged; Anticoagulants - therapeutic use; Anticoagulation; Betacoronavirus - isolation & purification; Coronavirus Infections - complications; COVID 19; Enoxaparin - therapeutic use; Female; Fibrinolytic Agents - therapeutic use; Humans; Male; Middle Aged; Pandemics; Pneumonia, Viral - complications; Pulmonary embolism; Pulmonary Embolism - diagnosis; Pulmonary Embolism - drug therapy; Pulmonary Embolism - etiology; Pyrazoles - therapeutic use; Pyridones - therapeutic use; Rivaroxaban - therapeutic use; SARS-CoV-2; Thrombolysis; Tissue Plasminogen Activator - therapeutic use; Pulmonary embolism; Anticoagulation; COVID 19; Thrombolysis
• ISSN: 0049-3848; 1879-2472
• DOI: 10.1016/j.thromres.2020.05.033

The Coronavirus Disease 2019 (COVID 19) has been reported in almost every country in the world. Although a large proportion of infected individuals develop only mild symptoms or are asymptomatic, the spectrum of the disease among others has been widely variable in severity. Additionally, many infected individuals were found to have coagulation markers abnormalities. This is especially true among those progressing to severe pneumonia and multi-organ failure. While the incidence of venous thromboembolic (VTE) disease has been recently noted to be elevated among critically ill patients, the incidence among ambulatory and non-critically ill patients is not yet clearly defined. Herein, we present six patients who didn't have any hypercoagulable risk factors yet presented with pulmonary embolism in association with COVID 19 infection. Furthermore, we discuss the possible underlying mechanisms of hypercoagulability and highlight the possibility of underdiagnosing pulmonary embolism in the setting of overlapping symptoms, decreased utilization of imaging secondary to associated risks, and increased turnover times. In addition, we emphasize the role of extended thromboprophylaxis in discharged patients.