Abstract
A 53-year-old man with diabetes came to the emergency department with fever and dry cough for 5 days, swelling of the left leg for 2 days, shortness of breath and chest pain for 1 hour. He had raised temperature, tachycardia, tachypnoea, reduced oxygen saturation and swollen tender left leg on examination. The frontal chest radiograph showed bilateral ground-glass opacities; he tested positive for COVID-19 with elevated D-dimer. The colour Doppler examination of the left leg revealed acute deep vein thrombosis (DVT) of the common femoral and the popliteal veins. The chest CT showed bilateral diffuse ground-glass opacities predominantly involving peripheral zones and the lower lobes. The CTPA revealed left pulmonary thromboembolism (PTE), treated with low-molecular-weight heparin. COVID-19 predominantly affects the respiratory system. DVT and PTE are common in COVID-19 but lethal. They should be diagnosed early by clinical and radiological examinations and treated promptly with anticoagulants.
Keywords:
COVID-19; radiology (diagnostics); venous thromboembolism.
© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.
MeSH terms
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Adenosine Monophosphate / analogs & derivatives
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Adenosine Monophosphate / therapeutic use
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Alanine / analogs & derivatives
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Alanine / therapeutic use
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Anti-Bacterial Agents / therapeutic use
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Anticoagulants / therapeutic use
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Antiparasitic Agents / therapeutic use
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Antiviral Agents / therapeutic use
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COVID-19 / blood
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COVID-19 / complications*
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COVID-19 / diagnosis
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COVID-19 / therapy
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COVID-19 Drug Treatment
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Computed Tomography Angiography
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Diabetes Mellitus, Type 2 / complications
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Doxycycline / therapeutic use
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Femoral Vein
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Fibrin Fibrinogen Degradation Products
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Glucocorticoids / therapeutic use
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Heparin, Low-Molecular-Weight / therapeutic use
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Humans
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Ivermectin / therapeutic use
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Male
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Methylprednisolone / therapeutic use
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Middle Aged
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Oxygen Inhalation Therapy
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Popliteal Vein
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Pulmonary Embolism / diagnostic imaging
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Pulmonary Embolism / etiology*
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Pulmonary Embolism / therapy
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SARS-CoV-2
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Tomography, X-Ray Computed
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Ultrasonography, Doppler, Color
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Venous Thrombosis / diagnostic imaging
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Venous Thrombosis / etiology*
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Venous Thrombosis / therapy
Substances
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Anti-Bacterial Agents
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Anticoagulants
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Antiparasitic Agents
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Antiviral Agents
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Fibrin Fibrinogen Degradation Products
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Glucocorticoids
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Heparin, Low-Molecular-Weight
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fibrin fragment D
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remdesivir
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Adenosine Monophosphate
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Ivermectin
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Doxycycline
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Alanine
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Methylprednisolone