id	author	title	date	pages	extension	mime	words	sentences	flesch	summary	cache	txt
cord-254919-fi3inp67	Molina, Melanie F.	Nitrous oxide inhalant abuse and massive pulmonary embolism in COVID-19	2020-05-16		.txt	text/plain	694	42	51	title: Nitrous oxide inhalant abuse and massive pulmonary embolism in COVID-19 A patient presented to the emergency department with altered mental status and lower extremity weakness in the setting of nitrous oxide inhalant abuse and Coronavirus Disease-2019 (COVID-19) infection. Given the high concern for pulmonary embolism with the above findings, computed tomography (CT) was performed and analysis of 183 confirmed COVID-19 patients demonstrating an 11.5% death rate. This patient's coagulopathy may have been secondary to a combination of COVID-19 infection and N2O inhalant abuse leading to hyperhomocysteinemia. There are case reports illustrating a higher risk of VTE associated with chronic N2O inhalant abuse [6, 7] . Nitrous oxide leads to decreased Vitamin B12 levels with chronic abuse, which leads to increased homocysteinemia by inhibition of methionine synthase [7] . Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy Pulmonary embolism and deep vein thrombosis caused by nitrous oxide abuse: A case report	./cache/cord-254919-fi3inp67.txt	./txt/cord-254919-fi3inp67.txt