Case Report


More than meets the eye: Pulmonary embolism in an HIV patient with COVID-19 infection

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1 University Hospitals of Derby and Burton NHS Foundation Trust, Queens Hospital, Belvedere Road, Burton-on-Trent, DE13 0RB, Staffordshire, United Kingdom

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Nonyelum Obiechina

Department of General Medicine and Geriatric Medicine, University Hospitals of Derby and Burton NHS Trust,

United Kingdom

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Article ID: 101186Z01NO2020

doi: 10.5348/101186Z01NO2020CR

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How to cite this article

Obiechina N, Fernandez A, Agha A, Nandi A. More than meets the eye: Pulmonary embolism in an HIV patient with COVID-19 infection. Int J Case Rep Images 2020;11:101186Z01NO2020.

ABSTRACT


Introduction: Since the emergence of the novel coronavirus 2019 (COVID-19) pandemic, the understanding of its pathophysiology and clinical features has continued to unfold. COVID-19 causes acute respiratory distress syndrome (ARDS) along with other coronaviruses. In contrast to other coronaviruses, COVID-19 has been found to be associated with deep vein thrombosis, pulmonary embolism, and arterial thrombosis. Although COVID-19 is thought to have worse outcomes in immunocompromised patients, its relationship with human immunodeficiency virus (HIV) remains interesting. This is because COVID-19 has been shown to be similar in frequency of occurrence in HIV patients on anti-retroviral (ART) and in whom the viral load is low as in non-HIV patients. However, its incidence is higher in non-compliant HIV patients, similar to other immunosuppressed patients. In addition, both COVID-19 and HIV increase the risk of thrombo-embolic events.

Case Report: We present the case of a gentleman with HIV who developed COVID-19 and pulmonary embolism. We explore the proposed mechanisms by which pulmonary embolism occurs in both conditions as well as their management.

Conclusion: Both HIV and COVID-19 increase the risk of thrombo-embolic events. Sudden deterioration in these patients or increase in their oxygen requirement should alert clinicians to the possibility of concomitant pulmonary embolism.

Keywords: COVID-19, Coronaviruses, HIV, Pulmonary embolism

SUPPORTING INFORMATION


Author Contributions

Nonyelum Obiechina - Conception of the work, Design of the work, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Ancy Fernandez - Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Adnan Agha - Conception of the work, Design of the work, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Angela Nandi - Conception of the work, Design of the work, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Guarantor of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2020 Nonyelum Obiechina et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.