Massive pulmonary embolism following recovery from COVID-19 infection: inflammation, thrombosis and the role of extended thromboprophylaxis

BMJ Case Rep. 2020 Sep 13;13(9):e238168. doi: 10.1136/bcr-2020-238168.


COVID-19 is the infectious disease caused by a recently discovered SARS-CoV-2. Following an initial outbreak in December 2019 in Wuhan, China, the virus has spread globally culminating in the WHO declaring a pandemic on 11 March 2020. We present the case of a patient with an initial presentation of COVID-19 pneumonitis requiring mechanical ventilation for nearly 2 weeks and total admission time of 3 weeks. She was given prophylactic dose anticoagulation according to hospital protocol during this time. Following a week at home, she was readmitted with acute massive pulmonary embolism with severe respiratory and cardiac failure, representing the first such case in the literature.

Keywords: adult intensive care; pulmonary embolism.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / therapeutic use*
  • COVID-19
  • Coronavirus Infections / complications*
  • Female
  • Humans
  • Inflammation / virology*
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pulmonary Embolism / virology*
  • Severity of Illness Index
  • Thrombosis / drug therapy*
  • Thrombosis / virology*


  • Anticoagulants