Asthma patient with COVID symptoms

Male patient in early 20s, PMH of asthma, COVID symptoms, hypoxia, admitted to ICU, CXR on admission, not tubed, CPAP worked and the patient discharged after a week, only to return a month later with pleuritic chest pain. CTPA demonstrated emboli and cavitations, likely secondary to superimposed bacterial infection, image 2 onwards show CXR and CT on second admission. How do you think this patient- now anticoagulated - be managed?

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Cxray shows bil diffuse parenchymal reticulonoduler infiltration with basal heziness more on right side. CT thorax showing rt sided encysted Hydropneumothorax, bil patchy areas of consolidation and GGos.
This case suggest thrombotic theory of covid19 As pt had mild pulmonary complaints earlier recovered to return back with thromboembolic changes in lungs as seen from ct thorax yes right step anticoagulated It support italian observation to give ASPIRIN earliest
Thanx dr Ashok Leel
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It has been demonstrated that Covid infection can recur. This looks COVID infection,- bilateral pneumonia, respiratory failure , thromboembolic phenomenon due to DIVC, RTPCR for COVID, sputum for AFBand CBNATT, All investigations related to hypercoagulable state like protein S, protein C, Lupus antibody, phospholipid antibody , hyperfibrogenemia should be checked , since this patient is young. Anticoagulants are required in this case, but risk of pulmonary bleeding is real .
B/ l collapse and inflitration . Covid Infection. Needs admission in covid centre and further investigation and evaluation to conclude or otherwise. TT as per protocol.
Thanks Dr Shivraj Agarwal
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B/L collapse consolidation COVID infection Ref to COVID centre
SUGGESTIVE. Of COLLAPSE CONSOLIDATION
No alternative start anticoagulation known pt of covid with emboli
Bilateral multiple collapse j consolidatiom
Lachesis 1m/3dose Carbo veg 30/qds

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