An abrupt fatal hemothorax in a stable COVID-19 patient: a case report with literature review
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Updated: Jun 27, 2025
Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock
Published on: May 19, 2022
Mike Ghabally1, Baraa Shebli1, Hassan Yahaya2
1Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Aleppo.
Introduction And Importance:
COVID-19 has been widely spread in the last 2 years. Hemothorax is considered one of the rarest complications of COVID-19.
Case Presentation:
The authors herein report a case of a 52-year-old patient of COVID-19 that was complicated with abrupt massive hemothorax with hemodynamic instability. Emergent thoracostomy drained almost 4500 ml of blood within 48 h. Thoracoscopy was also performed draining an additional 2000 ml of blood and clots. No further bleeding occurred. Unfortunately, the patient died of septic shock and multiorgan dysfunction.
Clinical Discussion:
Hemothorax has been reported in seven patients with COVID-19 in the medical literature. Six patients had severe infection with veno-venous extra-corporeal membranous oxygenation (VV-ECMO), and the seventh patient had necrotizing pneumonia. To our knowledge, this represents the first patient of an abrupt massive hemothorax in a COVID-19 patient just before recovery.
Conclusion:
Post-COVID-19 hemothorax should be suspected in severe cases with sudden clinical deterioration and evidence of pleural effusion.
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