COVID-19 pneumonia with hemoptysis: Acute segmental pulmonary emboli associated with novel coronavirus infection

Am J Emerg Med. 2020 Jul;38(7):1544.e1-1544.e3. doi: 10.1016/j.ajem.2020.04.011. Epub 2020 Apr 8.

Abstract

Recent retrospective studies from Wuhan, China suggest Novel Coronavirus Disease 2019 (COVID-19) may be associated with a hypercoagulable state and increased risk for venous thromboembolism. The overlap in the signs and symptoms of COVID-19 associated Acute Respiratory Distress Syndrome (ARDS) and COVID-19 with concurrent pulmonary embolism creates a diagnostic challenge for emergency medicine physicians in patients already at risk for renal impairment. However, identifying features atypical for COVID-19 alone may play a role in the judicious use of Computed Tomography Angiography among these patients. Hemoptysis is seen in roughly 13% of pulmonary embolism cases and infrequently reported among COVID-19 infections. Additionally, the presence of right heart strain on electrocardiography (EKG) is a well described clinical presentations of pulmonary embolism not reported commonly with COVID-19 infections.

Keywords: COVID-19; Coronavirus; Pulmonary embolism; SARS-CoV-2; Venous thromboembolism.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Betacoronavirus
  • COVID-19
  • Computed Tomography Angiography
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnosis
  • Electrocardiography
  • Hemoptysis / etiology*
  • Humans
  • Male
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / diagnosis
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / virology*
  • SARS-CoV-2
  • Venous Thromboembolism / diagnostic imaging
  • Venous Thromboembolism / virology*