Davoodi Lotfollah, Jafarpour Hamed, Taghavi Morteza, Razavi Alireza
Department of Infectious Diseases, School of Medicine, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
J Investig Med High Impact Case Rep. 2020 Jan-Dec;8:2324709620931239. doi: 10.1177/2324709620931239.
On December 31, 2019, the World Health Organization was informed of a cluster of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province, China. The pneumonia was caused by a virus called SARS-Cov-2 (severe acute respiratory syndrome coronavirus 2), which was later named coronavirus infectious disease 2019 (COVID-19). The symptoms most commonly reported by patients affected by COVID-19 include fever, dry cough, and shortness of breath. In this report, we present a case of a 57-year-old woman who presented to the clinic's infectious department with swelling, pain, warmth, and redness in the left leg who was treated with therapeutic heparin. There were no typical and distinguished symptoms of COVID-19, and she had no risk factor for deep vein thrombosis. Then chest X-ray revealed bilateral patchy ground-glass opacity, and computed tomography angiography was performed to rule out pulmonary thromboembolism, which showed no evidence of thrombosis. Left lower limb venous color Doppler ultrasound revealed dilatation and thrombosis in the external iliac and left iliac veins up to the level of the bifurcation of the common iliac veins, as well as thrombosis to the superficial and small saphenous veins. Because of ground-glass opacity and lymphopenia, nasal swabs were used for sampling, and SARS-CoV-2 nucleic acid was detected by reverse transcription polymerase chain reaction (RT-PCR). This case aims to arouse the medical staff's awareness of deep vein thrombosis as a clinical symptom of COVID-19 even if the patient has no typical symptoms of COVID-19.
2019年12月31日,世界卫生组织收到通报,在中国湖北省武汉市发现了一批病因不明的肺炎病例。这种肺炎是由一种名为严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的病毒引起的,该病毒后来被命名为2019冠状病毒病(COVID-19)。感染COVID-19的患者最常报告的症状包括发热、干咳和呼吸急促。在本报告中,我们介绍了一例57岁女性病例,该患者因左腿肿胀、疼痛、发热和发红就诊于诊所感染科,接受了肝素治疗。该患者没有COVID-19的典型和明显症状,也没有深静脉血栓形成的危险因素。随后胸部X光显示双侧斑片状磨玻璃影,进行了计算机断层血管造影以排除肺血栓栓塞,结果显示没有血栓形成的证据。左下肢静脉彩色多普勒超声显示,髂外静脉和左髂静脉直至髂总静脉分叉处扩张并形成血栓,浅静脉和小隐静脉也有血栓形成。由于存在磨玻璃影和淋巴细胞减少,采集了鼻拭子样本,通过逆转录聚合酶链反应(RT-PCR)检测到SARS-CoV-2核酸。本病例旨在提醒医务人员,即使患者没有COVID-19的典型症状,深静脉血栓形成也可能是COVID-19的临床症状之一。