key: cord-0770135-36u8me7l
authors: Cellina, M.; Oliva, G.
title: Acute pulmonary embolism in a patient with COVID-19 pneumonia
date: 2020-04-10
journal: Diagn Interv Imaging
DOI: 10.1016/j.diii.2020.04.001
sha: ce1d3443c3d6c1b84a75b9ad923f6d589e3783b6
doc_id: 770135
cord_uid: 36u8me7l

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. 60-year-old man with COVID-19 pneumonia and acute pulmonary embolism. A. Unenhanced CT image in the axial plane (mediastinal window: W 410/L 10 HU) shows spontaneously hyperattenuating clot (arrow) in the left main pulmonary artery. B. CT image in the axial plane (mediastinal window: W 410/L 10 HU) obtained after intravenous administration of iodinated contrast material confirms thrombus in the left main pulmonary artery (arrow) and reveals contralateral thrombus in the right interlobar artery(arrowhead). C. CT image in the coronal plane (mediastinal window: W 410/L 10 HU) depicts filling defects in the left main pulmonary artery (arrow) and right interlobar artery (arrowhead). D. CT image in the coronal plane (lung window: W 1600/L-500 HU) shows diffuse involvement of upper right lobe by ground-glass opacities, interlobular septal thickening, peribronchovascular consolidations and perihilar bronchial wall thickening.

Computed tomography revealed acute bilateral pulmonary embolism and findings consistent with COVID-19 pneumonia (Fig. 1) . COVID-19 belongs to the family of betacoronavirus and shares similar imaging and clinical features with SARS and Middle East respiratory syndrome coronavirus (MERS); however, no cases of acute pulmonary embolism have been reported in MERS and only one in severe acute respiratory syndrome. [1] . Elevated D-dimer values are common in COVID-19 patients, even in the absence of thrombophlebitis and acute pulmonary embolism [1] . Our observation highlights the fact that in patients with COVID-19 pneumonia presenting with worsening of clinical respiratory symptoms, chest CT angiography should be performed to detect superimposed acute pulmonary embolism. All clinicians involved in this emergency should be aware of this issue.

Findings of acute pulmonary embolism in COVID-19 patients