Acute pulmonary embolism as the first manifestation in a COVID-like severe acute respiratory syndrome.

In the era of new coronavirus infection pulmonary embolism (PE) is a corollary manifestation that may aggravate the patient`s clinical status. In this setting of patients various coagulation abnormalities such as raised D-dimers and prolonged APTT have been reported previously in up to 65% and 45% of adults SARS patients respectively and multiple previously necropsy series of SARS patients showed that vascular thromboses were not uncommonly seen in lung specimens. During this period emergency rooms work is note of worthy in differentiation COVID from non-COVID patients due to separate admission procedure in the hospital. Accordingly, among the non-COVID population there exist a high percentage of patients with a typical radiologic pattern of COVID-19 but without a positive reverse transcription polymerase chain reaction (RT-PCR) resulting in naso-faringeal swamp. The above findings raise the suspicion of an occulted COVID-19 or a like-COVID-19 clinical presentation. In the last istance there is a need to pay more attention just to avoid further contamination. In this report we describe a case with high risk PE, as a first manifestation of a like- COVID-19 pneumonia. In the above case the patient in question, after careful CT angiography evaluation, has a clear COVID-19 pneumonia radiological findings in spite of three RT-PCR swamp negative for true COVID-19.