Hemoptysis in COVID-19 pulmonary embolism patient: a case report

Background: Coronavirus disease 2019 (COVID-19) is related to hypercoagulability and venous thromboembolism (VTE). The overlapping symptoms of COVID-19 linked to acute respiratory distress syndrome (ARDS) and COVID-19 with concomitant pulmonary embolism (PE) provide a diagnostic difficulty for emergency physicians. This case study aims to evaluate the hemoptysis in COVID-19 pulmonary embolism patient. Case presentation: A 46-year-old woman with COVID-19 complained of a bloody cough (estimated 10 ml). She had COVID-19 five days before presenting. Vital signs were normal, but the respiratory rate went 30 times per minute. A lab test revealed 838.64 ng/ml of D-dimer. A chest x-ray showed bilateral lower lobes opacity. The first HRCT showed consolidation with fibrosis and minimal traction bronchiectasis in the 7th and 8th segment of the right lower lobe, an atypical sign of a COVID-19 lesions. The patient was later hospitalized in a negative pressure chamber, given heparin for 72 hours, and discharged on an oral anticoagulant. Conclusions: This is one of the first reports of segmental PE in a COVID-19 patient with no VTE risk factor. Emergency care doctors must be aware of the possible link between COVID-19 and PE. Hemoptysis is uncommon in PE patients and is seldom documented in COVID-19 infections. All suspected or confirmed COVID-19 patients should begin thromboprophylaxis to avoid morbidity and death.