BACKGROUND: The emergence of a new strain of coronavirus infection, the coronavirus infection disease 2019 (COVID-19), has been a pandemic burden across the globe. Severe COVID-19, particularly in patients with acute respiratory distress syndrome (ARDS), is associated with increased risk of admission to intensive care unit (ICU), mechanical ventilation, and mortality. Bronchoscopy has been widely employed as an adjunctive therapy in mechanically ventilated patients. However, the use of bronchoscopy in patients with COVID-19 has been strictly limited due to aerosol transmission.
CASE REPORT: We reported 3 COVID-19 Cases presented to the hospital with ARDS. All of the patients were immediately intubated to improve oxygenation. During admission, the patients produced immense airway secretions that might have resulted in partial airway obstruction. A conventional tracheal suctioning did not help to promote clinical improvement. We decided to perform bronchoscopy with controlled suctioning by following a very tight protocol to prevent aerosol formation. A significant clinical and respiratory improvement was observed in all patients following bronchoscopy. Three of them were transferred to regular ward, however, one patient died during hospitalization.
CONCLUSION: Bronchoscopic procedures may provide significant therapeutic benefits in severe COVID-19 patients. However, it should be kept in mind that this procedure should only be performed with a rigorous protocol to reduce the risk of aerosol generation and subsequent viral transmission.
Since its first discovery in late 2019, coronavirus disease 2019 (COVID-19) has been a global burden associated with significant morbidity and mortality. COVID-19 has been correlated with the development of hypercoagulable state that predisposes the patients to a higher risk of thromboembolism. Current evidence suggests higher incidence of thrombosis, particularly venous thrombosis, among hospitalized COVID-19 patients, mostly with critical illness. On the other hand, there is currently no data regarding the incidence of vivid thrombosis in ambulatory patients with mild COVID-19 and the incidence of concomitant arterial and venous thrombosis in COVID-19 is extremely rare. Herein, we describe catastrophic outcomes of concomitant lower limb arterial and venous thrombosis in a patient with mild COVID-19. This report highlights the occurrence of concomitant arterial and venous thrombosis in ambulatory setting and that this phenomenon resulted in catastrophic clinical consequences.
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