Table 1.

Case series

CharacteristicCase 1Case 2Case 3
Age498160
ComorbiditiesAsthma and bronchiectasisCOPD, hypertensionProstate cancer
SexMaleFemaleMale
Length of illness prior to admission date (days)23182
Symptoms at onsetDry cough, fever, anosmia, pleuritic chest painDyspnoea, persistent cough, feverDyspnoea
Imaging featuresPatchy peripheral airspace opacification on CXRBilateral multifocal consolidation on CXRBilateral ground glass opacification on CT
Clinical courseFollowing admission with type 1 respiratory failure and pleuritic chest pain, a CTPA was performed on day 2 demonstrating bilateral pulmonary emboli. Due to low anti-factor Xa levels despite treatment with tinzeparin (175 units/kg) he was switched to enoxaparin 1 mg/kg BD.Admitted with type 1 respiratory failure tachycardia and fever. Persistent tachycardic and hypoxic on day 3 of admission. A CTPA demonstrated extensive bilateral pulmonary emboli. Due to low anti-factor Xa levels despite treatment with tinzaparin (175 units/kg) she was switched to enoxaparin 1mg/kg BD.Intubated in emergency department due to profound hypoxia. On day 8 lower limb swelling noted. USS diagnosed common and superficial femoral vein thrombus. Pulmonary embolus on CTPA. Despite intravenous heparin the APTT ratio was subtherapeutic. Switched to argatroban and clinically improved to discharge from critical care.
Critical care admissionNNY
VTEPEPEDVT and PE
Laboratory findings on admission
Positive PCR for SARS-CoV-2NNY
WCC 109/L12.1811.2
Lymphocyte count 109/L1.20.40.3
CRP mg/L36758247
INR1.21.11.1
APTT ratio1.211.2
Fibrinogen g/L9.97.36.8
D-dimer ug/ml FEU3.323.3119.38
Troponin ng/L5.19269
Special haematology
Initial anti-Xa IU/ml (0.4–1.0)0.30.38
Repeat anti-Xa IU/ml0.410.52
Antithrombin % (84–119)849974
Von Willebrand factor antigen % (50–140)338210762
Factor VIIIc u/dL (60–150)341205506
  • APTT = activated partial thromboplastin time; CTPA = CT pulmonary angiogram; CRP= C-reactive protein; DVT = deep vein thrombosis; INR = international normalised ratio; PE = pulmonary embolism; VTE = venous thromboembolism.