Unusual Presentation of COVID-19 in a Child Complicated by Massive Acute Pulmonary Embolism and Lung Infarction

Ali, Tahani Bin; Elyamany, Ghaleb; Nojoom, Maha; Alfaki, Mohamed; Alahmari, Hassan; Alharthi, Abdulwahab; Hijazi, Muwaffak; Alsahari, Atif; Alabbas, Fahad; Al-Otaibi, Abdulnasir

doi:10.4081/hr.2021.8874

Cited by 2 publications

(1 citation statement)

References 10 publications

(11 reference statements)

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“…Body mass index ≥ 25 has been described as a risk factor 4 and is a frequent feature observed in the published cases (Table 2). COVID-19-related PE in children is an uncommon but potentially life-threatening finding, so these patients require ICU monitoring and mechanical ventilation, especially those with multisystem inflammatory syndrome (MIS-C) [10][11][12] or bilateral pulmonary involvement 12,13 . Our patient had no evidence of hemodynamic compromise; however, he was under continuous monitoring and constant medical evaluation.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary embolism in an adolescent with COVID-19 pneumonia

Nuñez-Paucar,

De Coll-Vela,

Peña-Coello

et al. 2023

BMHIM

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Background: Pulmonary embolism (PE) is a complication reported in the adult population with coronavirus disease 2019 ; however, its documentation in the pediatric population is limiteda. Case report: We report the case of a 15-yearold male with obesity and Down syndrome who was admitted for severe COVID-19 pneumonia. On day 7 of admission, he presented with chest pain, hemoptysis, respiratory distress, and marked elevation of D-dimer. Pulmonary CT angiography found an extensive thrombus in the right lower lobar artery. He received treatment with enoxaparin and rivaroxaban and had a favorable clinical outcome. In the tomographic control 1 month after treatment, thrombus was not evidenced and was successfully resolved. Conclusions: There are few reports of PE in children with COVID-19. Prompt diagnosis and early anticoagulant treatment are important to avoid life-threatening complications.

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Section: Discussionmentioning

confidence: 99%

Pulmonary embolism in an adolescent with COVID-19 pneumonia

Nuñez-Paucar,

De Coll-Vela,

Peña-Coello

et al. 2023

BMHIM

View full text Add to dashboard Cite

show abstract

Thromboembolic complications in children with COVID-19 and MIS-C: A narrative review

et al. 2022

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COVID-19 and multisystem inflammatory syndrome in children (MIS-C) have been associated with a higher incidence of hypercoagulability and thromboembolic events (TEs), even in children, leading to relevant morbidity, and mortality. However, our understanding of such complications in childhood is limited. To better understand the incidence, clinical manifestations, risk factors, and management of COVID-19 and MIS-C-related TEs in children, a review of the current literature and a brief update on pathophysiology are given. Sixty-two studies, describing 138 patients with TEs associated with COVID-19 or MIS-C, were included. The overall number of TEs was 157, as 16 patients developed multiple TEs: venous TEs represented the majority (54%), followed by arterial thrombosis (38%, mainly represented by arterial ischemic stroke-AIS), and intracardiac thrombosis (ICT) (8%). Within the venous TEs group, pulmonary embolism (PE) was the most frequent, followed by deep venous thrombosis, central venous sinus thrombosis, and splanchnic venous thrombosis. Notably, 10 patients had multiple types of venous TEs, and four had both venous and arterial thrombosis including a newborn. Most of them (79 cases,57%) had at least one predisposing condition, being obesity the most frequent (21%), especially in patients with PE, followed by malignancy (9%). In 35% of cases, no data about the outcome were available About one-third of cases recovered, 12% improved at discharge or follow-up, and 6% had persistent neurological sequelae. The mortality rate was 12%, with death due to comorbidities in most cases. Most fatalities occurred in patients with arterial thrombosis. Pediatricians should be aware of this life-threatening possibility facing children with SARS-CoV-2 infection or its multisystemic inflammatory complication, who abruptly develop neurological or respiratory impairment. A prompt intensive care is essential to avoid severe sequelae or even exitus.

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Unusual Presentation of COVID-19 in a Child Complicated by Massive Acute Pulmonary Embolism and Lung Infarction

Cited by 2 publications

References 10 publications

Pulmonary embolism in an adolescent with COVID-19 pneumonia

Pulmonary embolism in an adolescent with COVID-19 pneumonia

Thromboembolic complications in children with COVID-19 and MIS-C: A narrative review

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