| Case no.: | TL-00199 |
| Status: | Live (This case is available for Library users) |
| Title: | COVID-19 patient with hypoxemia |
| Background: A middle aged Chinese man with good past health was diagnosed to have COVID-19 by positive RT-PCR test for SARS-CoV-2. He developed hypoxemic respiratory failure 2 days after hospital admission. Blood test revealed high D-dimer level. CT pulmonary angiogram (CTPA) was performed. |
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| Question: | Which of the following feature(s) is/ are shown on CTPA? |
Possible
answers: |
| (a): | Multilobar consolidations |
| (b): | Multilobar ground glass opacities |
| (c): | Pulmonary embolism |
| (d): | All of the above(specified as the correct answer) |
| (e): | None of the above | |
| Reason: CT showed multilobar consolidations, ground glass opacities, and Right lower lobe segmental pulmonary embolism. |
| Further comments: Pulmonary embolism (PE) is a common complication among COVID-19 patients, and should be considered especially when patient develops hypoxemic respiratory failure. Multilobar ground glass opacities with or without consolidations are common CT scan findings of COVID-19. The patient was treated with dexamethasone, anticoagulation therapy and empirical antibiotics with good response and successfully discharged. |
| References: |
| 1: | Jevnikar M, Sanchez O, Chocron R, et al. Prevalence of pulmonary embolism in patients with COVID 19 at the time of hospital admission. Eur Respir J. 2021;2100116. doi:10.1183/13993003.00116-2021 |
| 2: | No reference 2 given for this case |
| 3: | No reference 3 given for this case | |
| Key words: |
| 1: | COVID-19 |
| 2: | Pulmonary embolism |
| 3: | CT pulmonary angiogram | |
| Submitted by: Charles Wong |
Assembly/
Specialty: | Respiratory Infections (non-tuberculous) |
| Institution: | Pamela Youde Nethersole Eastern Hospital, HKSAR |
| Address: | 3 Lok Man Road, Chai Wan, Hong Kong |
| Phone: | +852 25956111 |
| Fax: | / |
| Email: | respirologistlesarch@gmail.com |
| Level of difficulty: Intermediate |
| Willing to answer queries from users until: 29 Nov 2021 |
| Additional notes to APSR Case Reviewers: No note given for this case |
