Recurrent chronic thromboembolic disease despite optimal anticoagulation in setting of recent COVID-19 infection

BMJ Case Rep. 2021 Jan 28;14(1):e238733. doi: 10.1136/bcr-2020-238733.

Abstract

We present a case of a 38-year-old man with a history of chronic thromboembolic pulmonary hypertension on therapeutic anticoagulation and recent hospitalisation for COVID-19 disease who was hospitalised for recurrent acute pulmonary embolism despite therapeutic anticoagulation with warfarin (International Normalized Ratio (INR) of 3.0). Our case highlights the hypercoagulable state associated with COVID-19 disease and the absence of standardised approaches to anticoagulation treatment for this population.

Keywords: haematology (drugs and medicines); infectious diseases; pulmonary embolism; venous thromboembolism.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use*
  • COVID-19 / complications*
  • Chronic Disease
  • Diagnosis, Differential
  • Humans
  • Male
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Embolism / complications*
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / drug therapy*
  • SARS-CoV-2
  • Tomography, X-Ray Computed / methods
  • Warfarin / therapeutic use*

Substances

  • Anticoagulants
  • Warfarin