Spontaneous Renal Rupture and Hematoma in a Covid - 19 Case

Background: Covid-19 is a life-threatening disease-causing and accompanying multiple organ injuries in hospitalized patients. Case presentation: A 73-year-old male patient was admitted to a hospital in Tehran province. He had symptoms of COVID-19 disease, and his involvement with COVID-19 was confirmed by the molecular method and patchy areas of ground-glass opacities in the computed tomography (CT) scan. He was under treatment for his diabetes and hypertension. After a few hours of admission, he had low oxygen saturation (80%); hence he became under intensive care, oxygen, and anticoagulant therapy. On day 6 of ICU admission, his clinical status became worse when he had left side pain, hematuria, glucosuria, proteinuria, and high serum creatinine level (3.28 mg/dL). CT scan imaging was indicating of renal hematoma. The surgical or any invasive intervention was impossible due to the unstable status of the patient. Packed red cell and plasma replacement therapy were not effective in the prevention of expiration of the patient on day 7 of hospitalization. Spontaneous renal hemorrhage concurrent with COVID-19 disease was the defmite diagnosis for this case. Conclusion: We think that COVID-19 involvement may accelerate renal injury in our case. Anyhow, there were multiple predisposing risk factors for renal hematoma, in this case, such as diabetes, anticoagulant therapy, and COVID-19. We suggest that COVID-19 involvement accelerates renal problems. Nevertheless, this conclusion should be confirmed by other reports and research by clinical scientists.