id	author	title	date	pages	extension	mime	words	sentences	flesch	summary	cache	txt
cord-348422-werg9ofa	Shamsah, Mohammed A	Right atrial thrombus in a patient with COVID-19 pneumonia: a case report	2020-09-04		.txt	text/plain	1883	116	43	3 However, the case reported here represents an example of the need for therapeutic anticoagulant therapy in a specific group of severe COVID-19 pneumonia patients. We started the patient on high-dose norepinephrine, dobutamine, and vasopressin infusions, but his systolic pressure barely reached 90 mmHg. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was performed because of refractory shock, and catheter-directed thrombolysis with a 24-h infusion of alteplase was administered, followed by an infusion of unfractionated heparin. Some emerging case reports suggest that critically ill patients with COVID-19 develop complications from hypercoagulability, 5 including both pulmonary emboli 6 and microscopic thrombi. Thus, the hypercoagulable state in patients with COVID-19 is similar to that found in compensated DIC and might explain the absence of VA-ECMO was a lifesaving rescue therapy for our patient because of the high-risk, acute, massive pulmonary embolism. We believe that this is the first reported case of COVID-19 pneumonia with massive pulmonary embolism that was managed successfully with VA-ECMO and thrombolysis.	./cache/cord-348422-werg9ofa.txt	./txt/cord-348422-werg9ofa.txt