Case of COVID-19 infection and polycythaemia presenting with massive acute pulmonary embolism

We are reporting a middle-aged male patient with polycythaemia vera comorbidity. The patient was exhibiting symptoms including fever, cough and shortness of breath and was found to have acute pulmonary embolism. He was diagnosed with SARS-CoV-2. This case suggests that a high index of suspicion should be taken into consideration for thromboembolic events, when treating patients with COVID-19 with breathing difficulty and low oxygen saturation levels, especially in those who have underlying predisposing conditions for coagulopathy.

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Nintedanib in the management of pulmonary fibrosis after COVID-19: a case report

BIRDEM Medical Journal ◽

10.3329/birdem.v11i2.53139 ◽

2021 ◽

Vol 11 (2) ◽

pp. 148-152

Author(s):

Rajashish Chakrabortty ◽

Samia Rahman ◽

Rawnak Jahan ◽

Abir Hasan Dip ◽

Mohammed Mirazur Rahman

Keyword(s):

Computed Tomography ◽

Case Report ◽

High Resolution ◽

Pulmonary Fibrosis ◽

Oxygen Saturation ◽

Male Patient ◽

Shortness Of Breath ◽

Low Oxygen ◽

High Resolution Computed Tomography ◽

Novel Therapeutic

Pulmonary fibrosis is becoming a recognized complication of coronavirus disease 2019 (COVID-19). Patients with pulmonary fibrosis may present with dry cough, shortness of breath, nail clubbing, low oxygen saturation. We report a case of a 40-year-old male patient with pulmonary fibrosis due to COVID- 19. Clinical examination showed that the patient was dyspneic with low oxygen saturation and there was bilateral inspiratory crepitation in the lower part of his chest. High resolution computed tomography showed bilateral multifocal patchy ground-glass opacities, consolidation with peripheral and basal distribution, sub-pleural fibrotic bands and vascular thickening (almost 40-45% of parenchymal involvement). We prescribed him an antifibrotic drug, nintedanib and there was a significant clinical and radiological improvement after 15 days of treatment. Nintedanib may have novel therapeutic role in preventing COVID-19 associated fibrosis. Birdem Med J 2021; 11(2): 148-152

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Pulmonary emboli due to venous aneurysm of extremities

VASA ◽

10.1024/0301-1526/a000124 ◽

2011 ◽

Vol 40 (4) ◽

pp. 327-332 ◽

Cited By ~ 6

Author(s):

Gabrielli ◽

Rosati ◽

Vitale ◽

Millarelli ◽

Siani ◽

...

Keyword(s):

Pulmonary Embolism ◽

Surgical Resection ◽

Potential Risk ◽

Acute Pulmonary Embolism ◽

Prophylactic Surgery ◽

Venous Aneurysm ◽

Pulmonary Emboli ◽

Thromboembolic Events ◽

Thromboembolic Complications ◽

Risk Patients

Venous aneurysms are uncommon but they can have devastating consequences, including pulmonary embolism, other thromboembolic events and death. We report six cases of venous aneurysm of the extremities, in which the first sign of presence was acute pulmonary embolism. Surgical resection is recommended whenever possible. Our experience suggests that prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for extremity deep and superficial venous aneurysms for their potential risk of developing thromboembolic complications despite adequate anticoagulation. Other venous aneurysms should be excised only if they are symptomatic or enlarging.

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Tension Pneumothorax complicating COVID19 Pneumonia

10.22541/au.161383347.72886394/v1 ◽

2021 ◽

Author(s):

Amr Mohamed

Keyword(s):

Pulmonary Embolism ◽

Acute Pulmonary Embolism ◽

Tension Pneumothorax ◽

High Index ◽

Acute Decompensation ◽

High Index Of Suspicion

Acute decompensation in patient with COVID19 is usually a consequence of worsening ARDS , however acute pulmonary embolism and acute pneumothorax are frequently recognized causes of acute decompensation , the later causes are treatable and having high index of suspicion is very important in order not to miss them.

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Acute pulmonary embolism complicating deep vein thrombosis in a young patient with stroke

BIRDEM Medical Journal ◽

10.3329/birdem.v11i2.53137 ◽

2021 ◽

Vol 11 (2) ◽

pp. 142-144

Author(s):

Mohammed Mirazur Rahman ◽

Farjana Binte Habib ◽

Ahmed Imran Kabir ◽

Samprity Islam ◽

Rajashish Chakrabortty ◽

...

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Lower Limb ◽

Acute Pulmonary Embolism ◽

Successful Outcome ◽

Shortness Of Breath ◽

Vein Thrombosis ◽

Doppler Study ◽

Left Lower Limb ◽

Deep Vein

Acute pulmonary embolism is one of the most common causes of vascular death after myocardial infarction and cerebrovascular accidents. It usually presents with severe chest pain and shortness of breath and occasionally occurs in the background of deep vein thrombosis. A 32-year-old male presented with swelling of left lower limb and shortness of breath. Subsequent investigations revealed that he developed DVT of left lower limb and pulmonary embolism. However, in general, if left untreated, pulmonary embolism is associated with an overall mortality of up to 30 percent compared with 2 to 11 percent in those treated with anticoagulation. Early diagnosis by D-dimer, computed tomograpgy pulmonary angiogram and doppler study of the left lower limb and prompt intervention through low molecular weight heparin and rivaroxaban led to a successful outcome in our case. Birdem Med J 2021; 11(2): 142-144

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Association of elevated NTproBNP with recurrent thromboembolic events after acute pulmonary embolism

Thrombosis Research ◽

10.1016/j.thromres.2011.08.030 ◽

2012 ◽

Vol 129 (6) ◽

pp. 688-692 ◽

Cited By ~ 6

Author(s):

Yong Wang ◽

Zhi-hong Liu ◽

Hong-liang Zhang ◽

Qin Luo ◽

Zhi-hui Zhao ◽

...

Keyword(s):

Pulmonary Embolism ◽

Acute Pulmonary Embolism ◽

Thromboembolic Events

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Unprovoked acute pulmonary embolism increases the risk of recurrent thromboembolic events after acute pulmonary embolism

Heart ◽

10.1136/heartjnl-2011-300867.556 ◽

2011 ◽

Vol 97 (Suppl 3) ◽

pp. A189-A190

Author(s):

W. Yong ◽

Z. Hongliang ◽

Z. Zhihui ◽

L. Qin ◽

Z. Qing ◽

...

Keyword(s):

Pulmonary Embolism ◽

Acute Pulmonary Embolism ◽

Thromboembolic Events

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Admission Oxygen Saturation and Mortality in Acute Pulmonary Embolism Patients: Observational Data From Large ICU Databases

10.21203/rs.3.rs-580015/v1 ◽

2021 ◽

Author(s):

Xiaolin Xu ◽

Anping Peng ◽

Jing Tian ◽

Runnan Shen ◽

Guochang You ◽

...

Keyword(s):

Pulmonary Embolism ◽

Logistic Regression ◽

Intensive Care ◽

Hospital Mortality ◽

Oxygen Saturation ◽

Acute Pulmonary Embolism ◽

Research Database ◽

Optimal Range ◽

Subgroup Analyses ◽

The Relationship

Abstract Background The relationship between blood oxygenation and clinical outcomes of acute pulmonary embolism (APE) patients in intensive care unit (ICU) is unclear, which could be nonlinear. The study aimed to determine the association between admission pulse oximetry-derived oxygen saturation (SpO2) levels and mortality, and to determine the optimal range with real-world data. Methods Patients diagnosed with APE on admission and staying in ICU for at least 24 hours in the Medical Information Mart for Intensive Care III (MIMIC-III) database and the eICU Collaborative Research Database (eICU-CRD) were included. Logistic regression and restricted cubic spline (RCS) models were applied to determine the nonlinear relationship between mean SpO2 levels within the first 24 hours after ICU admission and in-hospital mortality, from which we derived an optimal range of SpO2. Subgroup analyses were based on demographics, treatment information, scoring system and comorbidities. Results We included 1109 patients who fulfilled inclusion criteria, among whom 129 (12%) died during hospitalization and 80 (7.2%) died in ICU. The RCS showed that the relationship between admission SpO2 levels and in-hospital mortality of APE patients was nonlinear and U-shaped. The optimal range of SpO2 with the lowest mortality was 95–98%. Multivariate stepwise logistic regression analysis with backward elimination confirmed that the admission SpO2 levels of 95%-98% was associated with decreased hospital mortality compared to the group with SpO2 < 95% (Odds ratio [OR] = 2.321; 95% confidence interval [CI]: 1.405–3.786; P < 0.001) and 100% (OR = 2.853; 95% CI: 1.294–5.936; P = 0.007), but there was no significant difference compared with 99% SpO2 (OR = 0.670, 95% CI: 0.326–1.287; P > 0.05). This association was consistent across subgroup analyses. Conclusions The relationship between admission SpO2 levels and in-hospital mortality followed a U-shaped curve among patients with APE. The optimal range of SpO2 for APE patients was 95–98%.

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