Sixty-two-year-old male patient with a diagnosis pneumonia due to SARS-CoV-2 infection in the hospitalization ward. Within the first 10 days the patient was treated with hydroxychloroquine, azithromycin, and enoxaparin at prophylactic doses and then with tocilizumab and methylprednisolone. On day 13 of the hospitalization (16 days since symptom onset), the patient remained with respiratory distress, severe hypoxemia, high D-dimer levels (>3000 ug/mL), and preserved hemodynamic stability. The computed tomography angiography performed revealed the presence of a pulmonary embolism in the right ventricle (Fig. 1A, black arrow). The echocardiogram confirmed the presence of a 2.4 cm thrombus in transit (Figure 1B and Figure C [white arrows] and supplementary data). The patient was then transferred to the intensive care unit where systemic fibrinolysis was performed with 100 mg of alteplase. Forty-eight hours later, the patient was discharged without further complications

Figure 1.

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