An “ordinary” case of COVID-19 pneumonia: when symptoms hide serious complications

COVID-19 pandemic changed quickly world’s clinical picture. Symptoms often are sneaky, hiding dramatic clinical scenarios. A 52-year-old man was sent to the Emergency Department with persistent chest pain, dyspnea and hypoxia. He also complained of cough and fever (38 °C) since four days without clinical improvements by paracetamol. Nasopharyngeal swab was positive for SARS-CoV-2. High resolution computer tomography (HRCT) showed typical CT pattern of bilateral COVID-19 pneumonia. During hospital stay clinical worsening occurred and a CT pulmonary angiography revealed a bilateral massive acute pulmonary embolism. The patient was treated with unfractionated heparin.