Unexpected Pulmonary Embolism Late After Recovery from Mild COVID-19?

Doranna De Pace; Sara Ariotti; Simone Persampieri; Giuseppe Patti; Alessandro Lupi

doi:10.12890/2021_002854

Unexpected Pulmonary Embolism Late After Recovery from Mild COVID-19?

Eur J Case Rep Intern Med. 2021 Dec 21;8(12):002854. doi: 10.12890/2021_002854. eCollection 2021.

Authors

Doranna De Pace¹, Sara Ariotti¹, Simone Persampieri¹, Giuseppe Patti², Alessandro Lupi¹

Affiliations

¹ Cardiology Division, Ospedale Unico Plurisede del VCO, Verbano-Cusio-Ossola, Italy.
² Clinica Cardiologica, AOU Maggiore della Carità, Università del Piemonte Orientale, Novara, Italy.

Abstract

SARS-CoV-2 infection is associated with an increased risk of venous thromboembolism (VTE), which is common during active illness but unusual in milder cases and after healing. We describe a case of bilateral acute pulmonary embolism occurring 3 months after recovery from a paucisymptomatic SARS-CoV-2 infection. The only VTE risk factor demonstrable was a history of previous SARS-CoV-2 infection, with laboratory signs of residual low-grade inflammation. Clinicians should be aware of VTE as a potential cause of sudden dyspnoea after COVID-19 resolution, especially in the presence of persistent systemic inflammation.

Learning points: Venous thromboembolism may occur after COVID-19, even in milder SARS-CoV-2 infections and late after coronavirus clearance.Laboratory signs of systemic inflammation are clues for suspecting venous thromboembolism as a cause of sudden dyspnoea in patients with low risk scores for pulmonary embolism but with previous COVID-19 infection.

Keywords: COVID-19; SARS-CoV-2; direct oral anticoagulants; inflammation; pulmonary embolism; thrombosis.