ABC | Volume 115, Nº1, July 2020

Case Report Passos et al. Pulmonary Thromboembolism in COVID-19 Arq Bras Cardiol. 2020; 115(1):142-145 of venous thromboembolism in patients hospitalized for COVD-19. In addition, anticoagulation should be considered in critically ill patients under intensive therapy, even with no clinical or imaging evidence of thrombosis, taking into consideration the risk of bleeding and potential benefit of interrupting the prothrombotic cascade, based on experts’ opinion and case series. Prospective studies are needed to confirm this benefit. 9,10 The elevations in D-dimer levels in severe forms of COVD-19 and superposition of respiratory symptoms over pulmonary thromboembolism symptoms make it difficult to Graph 1 – D-dimer profile during hospital course. Figure 2 – Computed tomography angiography of the chest: (yellow arrow) filling defect of the distal right pulmonary artery, extending to segmental branches of the right upper lobe, compatible with pulmonary thromboembolism. early diagnose the latter. Special attention must be paid to refractory hypoxemia, electrocardiographic alterations, sinus tachycardia that is not explained by current clinical condition and left ventricular dysfunction for diagnosis of pulmonary thrombosis and initiation of adequate anticoagulant therapy. Conclusion The SARS-Cov-2 infection has a variable phenotype, with common manifestations of cardiovascular complications and a prothrombotic state, by mechanisms not fully elucidated. Attention shouldbe given to superpositionof respiratory symptoms 144