Pulmonary Vein Thrombosis in COVID-19

Abstract

Research on COVID-19, the cause of a rapidly worsening pandemic, has led to the observation of laboratory derangements such as a propensity towards a hypercoagulable state. However, there are currently no reports on the incidence of pulmonary venous thrombosis in the setting of COVID-19. We report a case in which follow-up chest CT scans revealed an expansile filling defect in a branch of the right inferior pulmonary vein, which is consistent with pulmonary venous thrombosis. Our objective was to provide insight into an uncommon sequela of COVID-19 and consequently garner increased clinical suspicion for pulmonary VTE during hospitalization.

Keywords: COVID-19; imaging; pulmonary; thrombosis.

Figure 1

Axial CT scan of the chest shows features that are consistent with COVID-19: scattered peribronchovascular and peripheral mid to lower lung predominant ground-glass opacities and consolidations.

Figure 2

Axial contrast enhanced CT images of the chest: nonocclusive filling defect within the lateral basilar segmental pulmonary artery (white arrow), which is consistent with pulmonary arterial thromboembolic disease.

Figure 3

A, Axial, B, coronal, and C, sagittal contrast enhanced CT images of the chest: filling defect with focal distention of a branch of the right inferior pulmonary vein (white arrows), consistent with occlusive pulmonary venous thrombosis.