Right atrial thrombus and pulmonary embolism in a young adult with COVID‑19 and tuberculosis coinfection: a case report.

BACKGROUND

Coronavirus Disease 2019 (COVID-19) has been linked to thromboembolic complications, especially in severely ill patients. Intracardiac thrombi are uncommon and pose a very high risk. Coinfection with tuberculosis (TB) may worsen the prothrombotic state and complicate treatment. A 21-year-old male patient from Afghanistan developed active pulmonary tuberculosis (TB) and COVID-19. He had a large, mobile thrombus in the right atrium and an acute pulmonary embolism (PE), but no deep vein thrombosis (DVT). He received remdesivir, anti-TB medication, anticoagulation, and underwent a successful surgical embolectomy. At a nine-month follow-up, he remained symptom-free.

CONCLUSION

This case highlights the rare occurrence of a right atrial thrombus in COVID-19, possibly exacerbated by TB co-infection. Early detection and tailored treatment, including surgery, are crucial to lowering mortality in these high-risk patients, but further research is needed to establish optimal management strategies and confirm the role of TB in thrombotic complications.