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

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 develo...

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Autores principales: Valenzuela-Vallejo, Laura, Corredor-Orlandelli, David, Alzate-Ricaurte, Sergio, Hernández-Santamaría, Valentina, Aguirre-Ruiz, Juan Felipe, Peña-Peña, Adwar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700756/
https://www.ncbi.nlm.nih.gov/pubmed/34940004
http://dx.doi.org/10.3390/clinpract11040105
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author Valenzuela-Vallejo, Laura
Corredor-Orlandelli, David
Alzate-Ricaurte, Sergio
Hernández-Santamaría, Valentina
Aguirre-Ruiz, Juan Felipe
Peña-Peña, Adwar
author_facet Valenzuela-Vallejo, Laura
Corredor-Orlandelli, David
Alzate-Ricaurte, Sergio
Hernández-Santamaría, Valentina
Aguirre-Ruiz, Juan Felipe
Peña-Peña, Adwar
author_sort Valenzuela-Vallejo, Laura
collection PubMed
description 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.
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spelling pubmed-87007562021-12-24 Hormonal Contraception and Massive Pulmonary Embolism in a COVID-19 Ambulatory Patient: A Case Report Valenzuela-Vallejo, Laura Corredor-Orlandelli, David Alzate-Ricaurte, Sergio Hernández-Santamaría, Valentina Aguirre-Ruiz, Juan Felipe Peña-Peña, Adwar Clin Pract Case Report 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. MDPI 2021-11-26 /pmc/articles/PMC8700756/ /pubmed/34940004 http://dx.doi.org/10.3390/clinpract11040105 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Valenzuela-Vallejo, Laura
Corredor-Orlandelli, David
Alzate-Ricaurte, Sergio
Hernández-Santamaría, Valentina
Aguirre-Ruiz, Juan Felipe
Peña-Peña, Adwar
Hormonal Contraception and Massive Pulmonary Embolism in a COVID-19 Ambulatory Patient: A Case Report
title Hormonal Contraception and Massive Pulmonary Embolism in a COVID-19 Ambulatory Patient: A Case Report
title_full Hormonal Contraception and Massive Pulmonary Embolism in a COVID-19 Ambulatory Patient: A Case Report
title_fullStr Hormonal Contraception and Massive Pulmonary Embolism in a COVID-19 Ambulatory Patient: A Case Report
title_full_unstemmed Hormonal Contraception and Massive Pulmonary Embolism in a COVID-19 Ambulatory Patient: A Case Report
title_short Hormonal Contraception and Massive Pulmonary Embolism in a COVID-19 Ambulatory Patient: A Case Report
title_sort hormonal contraception and massive pulmonary embolism in a covid-19 ambulatory patient: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700756/
https://www.ncbi.nlm.nih.gov/pubmed/34940004
http://dx.doi.org/10.3390/clinpract11040105
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