Left ventricular thrombus and pulmonary embolism: A case series of thrombosis in COVID‐19 in Thai patients

Nanthatanti, Nithita; Phusanti, Sithakom; Chantrathammachart, Pichika; Thammavaranucupt, Kanin; Angchaisuksiri, Pantep; Sungkanuparph, Somnuek

Thrombosis in COVID‐19 is increasingly recognized and is generally associated with a high mortality rate. The key clinical question of this report was whether COVID‐19 could be complicated with cardiac thrombus and pulmonary embolism in Asian population. We demonstrated the case series of thrombosis in Thai patients with confirmed severe acute respiratory syndrome coronavirus 2 infection. One patient had the first case of a large left ventricular thrombus, and three other patients had pulmonary embolism. All patients were male and had low absolute lymphocyte count, while lactate dehydrogenase level and d‐dimer were markedly elevated, especially at the time when the thrombosis was diagnosed. All patients had severe COVID‐19 with pneumonia. Two patients who needed mechanical ventilation were successfully extubated. After hospitalization for 13‐49 days, pneumonia and thrombosis improved and all of them could be discharged from the hospital. Thrombosis is common in COVID‐19 and could present in both arterial and venous sites even in Asian populations. d‐dimer is a strong marker to predict thrombosis and could be a prognostic predictor for severity of COVID‐19.