Hospitalist, Providence Holy Family Hospital, Spokane, Washington, USA
Hospitalist, Providence Sacred Heart Medical Center, Spokane, Washington, USA.
BMJ Case Rep. 2021 Jan 7;14(1):e241027. doi: 10.1136/bcr-2020-241027.
COVID-19 has serious thrombotic complications in critically ill patients; however, thrombus is not a typical presenting symptom. This case report describes a patient with no respiratory symptoms who presented to the emergency department with abdominal pain. The pain was attributed to renal thrombosis, but the patient was found to have no risk factors for thrombotic disease and subsequent hypercoagulable work-up was unremarkable. Pulmonary manifestations of COVID-19 infection were detected incidentally on the abdominal CT scan and confirmed via PCR test. The patient was isolated and went on to develop mild respiratory failure secondary to COVID-19 infection. This case suggests that unexplained thrombus in otherwise asymptomatic patients can be a direct result of COVID-19 infection, and serves as a call to action for emergency department clinicians to treat unexplained thrombotic events as evidence of COVID-19.
COVID-19 在危重症患者中可引发严重的血栓并发症；然而，血栓并不是典型的首发症状。本病例报告描述了一位无呼吸系统症状的患者，因腹痛至急诊就诊。腹痛归因于肾血栓形成，但患者无血栓性疾病的危险因素，且进一步的高凝状态检查无明显异常。COVID-19 感染的肺部表现是在腹部 CT 扫描中偶然发现的，并通过 PCR 检测得到证实。患者被隔离，随后因 COVID-19 感染发展为轻度呼吸衰竭。本病例提示，无明显症状的患者发生不明原因的血栓可能是 COVID-19 感染的直接结果，并呼吁急诊临床医生将不明原因的血栓性事件视为 COVID-19 的证据进行治疗。
