A coagulopathic conundrum of COVID-19

We present a case of an elderly male who presented to the hospital with a worsening cough and shortness of breath. Previous outpatient COVID-19 polymerase chain reaction test was negative, and the patient’s symptoms failed to improve despite one-week course of antibiotics. He presented to the hospital a few days later with worsening symptoms and a positive COVID-19 polymerase chain reaction test at this time. Patient was febrile, tachycardic, hypertensive, and was admitted to the intensive care unit due to desaturation on room air ultimately leading to intubation. CBC with differential showed evidence of thrombocytopenia, elevated INR/D-Dimer/fibrin split products/inflammatory markers, as well as decreased fibrinogen. He was treated for COVID-19 pneumonia and given platelets/cryoprecipitate/Vit K for suspected diffuse intravascular coagulation.