key: cord-0915851-yq5u0l9t
authors: Mariano, Rachel Zerbini; Ramos, Marcelo de Carvalho; Reis, Fabiano
title: COVID-19 and pulmonary embolism: Do not forget the association!
date: 2020-06-08
journal: Revista da Sociedade Brasileira de Medicina Tropical
DOI: 10.1590/0037-8682-0234-2020
sha: 63ea68d50c061876d012e2bf1869a2e9857245a4
doc_id: 915851
cord_uid: yq5u0l9t

nan

www.scielo.br/rsbmt I www.rsbmt.org.br 

Do not forget the association! Rachel Zerbini Mariano [1] , Marcelo de Carvalho Ramos [2] and Fabiano Reis [ A 32-year-old man was admitted to the emergency department with a history of headache, fever, chills, dry cough, and fatigue. Chest computed tomography (CT) revealed predominantly peripheral consolidations involving all pulmonary lobes. These opacities were more exuberant in the peripheral upper segment of the left lower lobe (Figure 1 A, black arrow) . Real-time polymerase chain reaction confirmed SARS-CoV-2 infection. An increase in blood D-dimer levels raised the suspicion of pulmonary thromboembolism, which was confirmed by CT pulmonary angiography (Figure 1B and C, white arrows) .

In December 2019, a novel viral pneumonia (subsequently named coronavirus disease [COVID-19] pneumonia) emerged in Wuhan, China 1,2 . The main CT findings associated with COVID-19 pneumonia are bilateral, subpleural, ground-glass opacities with illdefined margins, and a slight predominance in the right lower lobe, which includes predominantly peripheral ground-glass opacities, a crazy-paving pattern, and/or consolidation with air bronchograms of the middle and lower lung regions, usually with bilateral and multilobar involvement 1,2 . Abnormal CT pulmonary findings can be detected in asymptomatic patients and lung lesions can appear within 1-3 weeks of the onset of symptoms, peaking at around two weeks after onset 1,2 . Patients with diagnosed COVID-19 may also have acute pulmonary embolism 3 . In COVID-19 patients with raised D-dimer levels on admission or sudden clinical worsening, CT pulmonary angiography should be conducted. Although the etiology of pulmonary embolism associated with COVID-19 is still unclear 3 , adequate and accurate diagnosis can guide the appropriate treatment.

We offer our deepest thanks to the institutions that provided technical support for the development and implementation of this study.

Conception and design of the study, acquisition of data; MCR: Conception and design of the study, analysis and interpretation of data, final approval of the version to be submitted; FR: Conception and design of the study, acquisition of data, drafting the article, final approval of the version to be submitted.

COVID-19 -Computed tomography findings in two patients in Petrópolis

Chest radiography and computed tomography findings from a Brazilian patient with COVID-19 pneumonia

Pulmonary embolism in patients with COVID-19: time to change the paradigm of computed tomography

The authors declare that there is no conflict of interest.