A Severe COVID-19 Case Complicated by Right Atrium Thrombus

Area of Science:

• Cardiology
• Pulmonology
• Hematology

Background:

• Hospitalized patients with severe COVID-19 exhibit coagulation dysfunction.
• This dysfunction is linked to inflammation, hypoxia, platelet activation, endothelial damage, and stasis.
• Effective anticoagulation is crucial for managing severe COVID-19.

Observation:

• A 73-year-old male with severe COVID-19 developed acute respiratory failure requiring ICU admission.
• Despite prophylactic anticoagulation, a right atrial thrombus was detected via echocardiography.
• The patient remained hemodynamically stable but hypoxemic.

Findings:

• Therapeutic anticoagulation, replacing prophylactic enoxaparin, was initiated.
• The patient demonstrated significant clinical improvement.
• Follow-up echocardiography confirmed complete resolution of the right heart thrombus.

Implications:

• This case underscores the importance of diagnostic imaging in identifying thrombotic complications in severe COVID-19.
• Adequate anticoagulation therapy is vital for successful management and improved outcomes.
• Early detection and appropriate treatment of cardiac thrombi are critical in critically ill COVID-19 patients.