Open AccessPulmonary Embolism After Acute Spinal Cord Injury and COVID-19
Author(s) -
Thomas John Pisano,
Jaclyn Joki,
Beverly Hon,
Sara Cuccurullo
Publication year - 2020
Publication title -
american journal of physical medicine and rehabilitation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 101
eISSN - 1537-7385
pISSN - 0894-9115
DOI - 10.1097/phm.0000000000001578
Subject(s) - medicine , pulmonary embolism , deep vein , venous thrombosis , thrombosis , spinal cord injury , coronavirus , spinal cord , surgery , anesthesia , disease , covid-19 , infectious disease (medical specialty) , psychiatry
The coronavirus virus disease 2019 is best known for its pulmonary sequelae. Understanding of the disease process is rapidly growing, and the medical community already appreciates a hypercoagulable state associated with coronavirus virus disease 2019. Acute spinal cord injury has an inherent increased risk for venous thromboembolism. In this case report, the patient presented with bilateral lower limb weakness and sensory loss secondary to thoracic disc herniation. Incidentally, at the same time as the initial presentation, the patient was also found to have coronavirus virus disease 2019 without significant respiratory symptoms. During hospitalization, the patient developed extensive bilateral lower limb deep vein thrombosis despite chemoprophylaxis. Therapeutic anticoagulation was initiated, yet several days later, he developed pleuritic chest pain. Computed tomography angiography revealed bilateral pulmonary emboli. This case highlights the need for clinicians to have elevated vigilance with regard to screening and treatment for venous thromboembolism in high-risk patients, such as spinal cord injury with a concurrent diagnosis of coronavirus virus disease 2019.