A 65-Year-Old Woman With Massive Hemoptysis After COVID-19 Infection

A 65-year-old woman presented with a 7-day history of generalized weakness, cough, and hemoptysis described as streaks of blood during the first 2 days, and as half a cup to a cup of bright red blood with clots thereafter. Seven weeks earlier she was hospitalized with COVID-19 pneumonia for which she received supplemental oxygen with high flow nasal cannula, remdesivir, dexamethasone, and tocilizumab. Her medical history included stage 3a chronic kidney disease, multinodular goiter, hypertension, and type II diabetes mellitus. She denied recent use of anticoagulants or nonsteroidal antiinflammatory drugs. She denied any recent trauma including pulmonary contusion. The patient did not have any history of rash, hematuria, or known autoimmune disease preceding this episode of hemoptysis. The patient had previous tobacco use with a 20 pack-year history and quit 7 years ago. She did not use alcohol or other recreational drugs. Family history was notable for breast cancer in her mother. She had no history of recent travel or exposure to sick contacts.