Pulmonary Embolism or COVID-19 Pneumonia? A Case Report

Abstract

Background: Pulmonary embolism (PE) is the most serious clinical presentation of venous thromboembolism (VTE), a major cause of sudden death. In the current Coronavirus disease 2019 (COVID-19) pandemic, when a patient presents with respiratory symptoms, many serious possible non-Covid causes including PE may be considered the next priority after COVID-19 on the differential diagnosis list. Thus, the correct diagnosis may be delayed or missed, with grave consequences to the patient’s outcome and safety. Case Presentation: We herein present a case of a 63-year-old Iranian female who was admitted to our hospital showing symptoms of delirium superimposed on dementia. Soon after admission, she developed fever and respiratory symptoms. However, overestimating the likelihood of COVID-19 pneumonia and attributing the patient’s symptoms to this disease led to delayed diagnosis and treatment of pulmonary embolism, resulting in the patient’s death.Conclusions: During the COVID-19 pandemic, a high index of suspicion is required for the timely diagnosis of PE, especially in patients with identifiable risk factors. This is specifically true for patients who are unable to express their symptoms due to neurocognitive disorders.