An abrupt fatal hemothorax in a stable COVID-19 patient: a case report with literature review.

INTRODUCTION AND

IMPORTANCE

COVID-19 has been widely spread in the last 2 years. Hemothorax is considered one of the rarest complications of COVID-19.

CASE PRESENTATION: The authors herein report a case of a 52-year-old patient of COVID-19 that was complicated with abrupt massive hemothorax with hemodynamic instability. Emergent thoracostomy drained almost 4500 ml of blood within 48 h. Thoracoscopy was also performed draining an additional 2000 ml of blood and clots. No further bleeding occurred. Unfortunately, the patient died of septic shock and multiorgan dysfunction.

CLINICAL DISCUSSION: Hemothorax has been reported in seven patients with COVID-19 in the medical literature. Six patients had severe infection with veno-venous extra-corporeal membranous oxygenation (VV-ECMO), and the seventh patient had necrotizing pneumonia. To our knowledge, this represents the first patient of an abrupt massive hemothorax in a COVID-19 patient just before recovery.

CONCLUSION

Post-COVID-19 hemothorax should be suspected in severe cases with sudden clinical deterioration and evidence of pleural effusion.