A Rare Case: Pulmonary Thromboembolism And Pneumothorax Coexistence Secondary To Covid-19 Infection

Abstract

Acute respiratory disease caused by a novel coronavirus (SARS-CoV-2) type that was first detected in Wuhan, Hubei Province of China, has turned into a pandemic. The disease commonly presents with fever, cough, and malaise, and typically bilateral peripheral ground-glass areas are seen in thorax computed tomography. While it may present as mild upper respiratory tract infection or pneumonia, patients may also develop pulmonary thromboembolism (PTE) and pneumothorax. In our case, in a young male patient who was followed up for severe pneumonia due to Covid-19 infection, PTE, parenchymal cysts, and pneumothorax were detected. Although PTE is a common complication, cyst formation and pneumothorax are rare. We aimed to present this case because of the coexistence of multiple pulmonary complications despite the young age of the patient.

Keywords

• Pulmonary Thromboembolism
• Pneumothorax
• Covid-19

References

1. 1-World Health Organization. Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020 https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020 (Accessed on February 12, 2020).
2. 2-Cömert, Sevda Şener, and Nesrin Kıral. "COVID-19 Pnömonisinin Radyolojik Bulguları."
3. 3-Li, Xuemei, Tao Li, and Huihui Wang. "Treatment and prognosis of COVID-19: Current scenario and prospects." Experimental and Therapeutic Medicine 20.6 (2020): 1-1.
4. 4-Vakili, K., Fathi, M., Pezeshgi, A., Mohamadkhani, A., Hajiesmaeili, M., Rezaei-Tavirani, M., & Sayehmiri, F. (2020). Critical complications of COVID-19: A descriptive meta-analysis study. Reviews in Cardiovascular Medicine, 21(3), 433-442.
5. 5-Porfidia, A., Valeriani, E., Pola, R., Porreca, E., Rutjes, A. W., & Di Nisio, M. (2020). Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis. Thrombosis research, 196, 67-74.
6. 6-Boonyawat, Kochawan, et al. "Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis." Thrombosis journal 2020: 1-12.
7. 7-Chen, Nanshan, et al. "Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study." The Lancet 395.10223 (2020): 507-513.
8. 8-Zantah, Massa, et al. "Pneumothorax in COVID-19 disease-incidence and clinical characteristics." Respiratory Research 21.1 (2020): 1-9.

9. 9-Do Lago VC, Cezare TJ, Fortaleza CMCB, Okoshi MP, Baldi BG, Tanni SE. Does COVID-19 Increase the Risk for Spontaneous Pneumothorax?. Am J Med Sci. 2020;360(6):735-737.
10. 10-Gattinoni, Luciano, et al. "COVID-19 pneumonia: different respiratory treatments for different phenotypes?." (2020): 1099-1102.
11. 11-AKGÜL, Aslı Gül. ‘Pnömotoraks’. Journal of Clinical and Analytical Medicine, 55: 2.
12. 12-Sun R, Liu H, Wang X. Mediastinal emphysema, Giant Bulla, and pneumothorax developed during the course of COVID-19 pneumonia. Korean J Radiol. 2020;21:541
13. 13-Liu K, et al. COVID-19 with cystic features on computed tomography: a case report. Medicine. 2020;99:e20175.
14. 14-Tucker, Lara, et al. "Pneumothorax and Pneumomediastinum Secondary to COVID-19 Disease Unrelated to Mechanical Ventilation." Case reports in critical care 2020 (2020).
15. 15-Hameed, Mansoor, et al. "Pneumothorax In Covid-19 Pneumonia: A Case Series." Respiratory Medicine Case Reports (2020): 101265.
16. 16-Alharthy a. et al. Covid-19 with spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema in the intensive care unit: two case reports. Journal of Infection and Public Health. 10.1016/j.jiph.2020.12.019
17. 17-Demirel Kaya ve ark. ‘‘Standart Protokol ile Tedavi Edilen COVID-19 Pnömonisi Hastaları: Beş Yoğun Bakım Ünitesinin Gözlemsel Sonuçları’’ Turk J Intensive Care. 2020;18:1-13