Thrombus in Transit and Impending Pulmonary Embolism Detected on POCUS in a Patient with COVID-19 Pneumonia

Pramod Theetha Kariyanna¹, Naseem A. Hossain¹, Apoorva Jayarangaiah², Nimrah A. Hossain³, Vaibhavi Uppin¹, Sudhanva Hegde¹, Violeta Capric¹, Moro O. Salifu¹ and Samy I. McFarlane^1,

¹Department of Internal Medicine, State University of New York, Downstate-Health Science University, Brooklyn, New York, USA, 11203

²Division of Hematology and Oncology, Department of Internal Medicine, Jacobi Medical Center, Albert Einstein School of Medicine, New York, USA- 10461

³Department of Internal Medicine, New York Presbyterian- Brooklyn Methodist Hospital, Brooklyn, New York, USA- 11215

Cite this paper:
Pramod Theetha Kariyanna, Naseem A. Hossain, Apoorva Jayarangaiah, Nimrah A. Hossain, Vaibhavi Uppin, Sudhanva Hegde, Violeta Capric, Moro O. Salifu and Samy I. McFarlane. Thrombus in Transit and Impending Pulmonary Embolism Detected on POCUS in a Patient with COVID-19 Pneumonia. American Journal of Medical Case Reports. 2020; 8(8):225-228. doi: 10.12691/ajmcr-8-8-2

Abstract

Coronavirus disease 2019 (COVID-19) is a pandemic that started in China in December 2019 and carries a high risk of morbidity and mortality. To-date (4-22-2020) it affected over 2.6 million people and resulted in nearly 200,000 death worldwide mainly due to severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2). Among the major underlying pathophysiologic mechanisms in COVID 19 is hypercoagulability, leading to increased risk for deep vein thrombosis and pulmonary embolism that contribute to increased morbidity and mortality. In this report, we present the case of a 55-year-old man who presented with COVID-19 pneumonia, and was found to have a thrombus in transit by routine point of care ultrasound (POCUS). While computer tomography (CT) angiography is the test of choice, the utilization of point of care ultrasound (POCUS) has gained traction as an adjunctive means of surveillance for the development of VTE in patients with COVID-19. In this report, we discuss the clinical utility of POCUS in diagnosing thrombus in transit in COVID 19 populations.

Keywords:
COVID 19 SARS-Cov-2 Pneumonia deep vein thrombosis pulmonary embolism POCUS

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