Hematoma espontáneo atípico debido a enfermedad grave por COVID-19

Multiple manifestations and complications associated with COVID-19 have been described, including coagulation disorders. The infection is known to induce a prothrombotic state, however, bleeding events have also been reported in these patients. We present the case of a 52-year-old man hospitalized for SARS-CoV-2 pneumonia, with a history of diabetes mellitus, systemic arterial hypertension, obesity, smoking, and hyperuricemia, who presented to the emergency department due to severe symptoms of the disease. During his hospitalization, he developed hemodynamic instability with a significant decrease in hemoglobin concentration. Massive hemothorax and a large chest wall hematoma were documented. This case highlights the importance of considering both thrombotic events and bleeding, in order to detect early any suspected bleeding and thus reduce mortality.