Hormonal Contraception and Massive Pulmonary Embolism in a COVID-19 Ambulatory Patient: A Case Report

Clinics and Practice

Adwar Peña-Peña¹  Juan Felipe Aguirre-Ruiz¹  David Corredor-Orlandelli²  Laura Valenzuela-Vallejo²  Sergio Alzate-Ricaurte²  Valentina Hernández-Santamaría² 

[1] Internal Medicine Department Fundación Cardioinfantil—LaCardio, Bogotá 110111, Colombia;School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 110111, Colombia;

关键词: COVID-19;    pulmonary embolism;    thrombosis;    oral contraception;    massive embolism;   

DOI  :  10.3390/clinpract11040105

来源: DOAJ

【 摘 要 】

Coronavirus 19 disease (COVID-19) presents a highly variable clinical presentation and course, ranging from asymptomatic patients to rapidly progressive, fatal pneumonia. The known heterogeneous outcomes can affect both previously healthy patients and those with significant comorbidities, who develop clinical courses with possibly more multisystemic compromise. Likewise, the development of thrombotic phenomena during the acute course of the disease is associated with complications that worsen patient prognosis. We present a case report of a 45-year-old multiparous patient with a history of overweight and chronic use of oral hormonal contraception with low doses of levonorgestrel and estradiol as the only risk factors favoring the development of thrombotic events. During her outpatient COVID-19 clinical course, she developed massive pulmonary thromboembolism resulting in secondary obstructive shock, which required pharmacological thrombolysis. At discharge, hormonal contraception was considered contraindicated, and the patient was released from our institution with continued oral anticoagulant therapy. COVID-19 infection, contraceptive hormone therapy, and overweight are known risk factors for the development of thromboembolic events. The impact of their concomitance has not been studied to date. From our experience, we discuss the impact these risk factors have when present together and invite others to report similar cases.

【 授权许可】

Unknown