A 65-Year-Old Woman With Massive Hemoptysis After COVID-19 Infection

Lissette Orozco MD , Bruno DiGiovine MD
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Abstract

Case Presentation

A 65-year-old woman presented with a 7-day history of generalized weakness, cough, and hemoptysis described as streaks of blood during the first 2 days, and as half a cup to a cup of bright red blood with clots thereafter. Seven weeks earlier she was hospitalized with COVID-19 pneumonia for which she received supplemental oxygen with high flow nasal cannula, remdesivir, dexamethasone, and tocilizumab.
Her medical history included stage 3a chronic kidney disease, multinodular goiter, hypertension, and type II diabetes mellitus. She denied recent use of anticoagulants or nonsteroidal antiinflammatory drugs. She denied any recent trauma including pulmonary contusion. The patient did not have any history of rash, hematuria, or known autoimmune disease preceding this episode of hemoptysis.
The patient had previous tobacco use with a 20 pack-year history and quit 7 years ago. She did not use alcohol or other recreational drugs. Family history was notable for breast cancer in her mother. She had no history of recent travel or exposure to sick contacts.
65岁女性感染COVID-19后大咯血1例
病例表现:一名65岁女性,有7天全身性虚弱、咳嗽和咯血病史,前2天有条状血,此后半杯至一杯鲜红色血并有血块。七周前,她因COVID-19肺炎住院,接受高流量鼻插管补充氧、瑞德西韦、地塞米松和托珠单抗。病史包括3a期慢性肾病、多结节性甲状腺肿、高血压和II型糖尿病。她否认最近使用过抗凝血剂或非甾体类抗炎药。她否认最近有外伤包括肺挫伤。在咯血发作前,患者没有任何皮疹、血尿史或已知的自身免疫性疾病。患者既往吸烟20包年,7年前戒烟。她没有使用酒精或其他娱乐性药物。她的母亲有明显的乳腺癌家族史。她没有近期旅行史或与患病接触者接触史。
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