Open AccessLate Pulmonary Embolism after COVID-19 Pneumonia despite Adequate Rivaroxaban Treatment
Author(s) -
Giuseppe Di Tano,
Luigi Moschini,
Marco Loffi,
Gianluca Galeazzi,
Sophie Testa,
Gian Battista Danzi
Publication year - 2020
Publication title -
european journal of case reports in internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
H-Index - 1
ISSN - 2284-2594
DOI - 10.12890/2020_001790
Subject(s) - medicine , rivaroxaban , pneumonia , pulmonary embolism , antithrombotic , intensive care medicine , atrial fibrillation , covid-19 , disease , pharmacotherapy , warfarin , infectious disease (medical specialty)
SARS-CoV-2 infection may predispose patients to thrombotic disease. Patients with COVID-19 pneumonia who are receiving non-vitamin K antagonists or direct oral anticoagulants for chronic disease are usually switched to heparin treatment during hospitalization. However, information about the most appropriate antithrombotic therapy after the acute infection phase is lacking. Case Description: We report the case of a patient with chronic atrial fibrillation who was recently hospitalized for severe COVID-19 pneumonia. Four weeks after discharge he experienced an episode of an acute pulmonary embolism while on rivaroxaban therapy with adequate drug plasma levels, and in the absence of strong predisposing risk factors. Conclusion: This case highlights the risk of thrombotic complications after COVID-19 infection, raises some concern about their underlying mechanisms, and supports the use of effective anti-thrombotic therapy.