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. 2020 Nov 18;4(6):1–5. doi: 10.1093/ehjcr/ytaa387
27 March 2020 Hospital admission witd dyspnoea due to novel COVID-19 infection, confirmed by positive polymerase chain reaction (PCR). Oxygen saturation levels of 93% with 5 L. Treatment withantibiotics, chloroquine, and dalteparin 5000 IU once daily.
31 March 2020 Hospital discharge after apparent recovery from COVID-19 infection.
1 April 2020 Presentation at the emergency room with acute respiratory distress. Oxygen saturation levels of 95% with 15 L (non-rebreather mask). Electrocardiogram shows signs of right ventricular strain. Computed tomography scan thorax: bilateral sub-segmental pulmonary embolism and mass in the apex of the right ventricle. Echocardiography: dilated right ventricle with poor systolic function and mobile, multi-lobar mass in the apex suspect for thrombus. Treatment with dalteparin 12.500 IU once daily initiated.
3 April 2020 Repeat echocardiogram: thrombus right ventricular apex no longer present. Persisting respiratory distress despite maximum supplemental oxygen using OptiflowTM Nasal High Flow (FiO2 90% with 60 L).
7 April 2020 Persisting dyspnoea and hypoxia (oxygen saturation levels 87–88%) despite several days of optimal medical treatment (patient had a do not intubate policy). Palliative sedation was initiated. Patient passed away the same day. No autopsy was performed.