Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Case Report

Pulmonary embolism confounded with COVID-19 suspicion in a catatonic patient presenting to anesthesia for ECT: a case report

B. Naveen Naik, Nidhi Singh, Ashish S. Aditya, Aakriti Gupta, Nidhi Prabhakar, Sandeep Grover

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Catatonic patients may develop deep vein thrombosis (DVT) and pulmonary embolism (PE) due to prolonged periods of immobility. These life-threatening conditions demand prompt recognition and management. We describe the case of a patient with catatonia who presented to anesthesia for electroconvulsive therapy (ECT) at the outset of the current coronavirus disease 2019 pandemic. She complained of breathing difficulty and was suspected to have COVID-19 infection. On further evaluation, she was found to have DVT and PE and required oxygen therapy and intensive care management. The diagnostic delay in our patient would have probably not occurred, had it not been for the existing pandemic situation.


Pulmonary embolism;  Deep vein thrombosis;  Catatonia;  COVID-19


[1] P.E. Marik Aspiration pneumonitis and aspiration pneumonia N Engl J Med., 344 (2001), pp. 665-671

[2] B.T. Carroll Complications of catatonia J Clin Psychiatry., 57 (1996), p. 95

[3] H. Morioka, I. Nagatoma, K. Yamada, et al. Deep venous thrombosis of the leg due to psychiatric stupor Psychiatry Clin Neurosci., 51 (1997), pp. 323-326

[4] J. Barbuto Preventing sudden death during a catatonic episode Hosp Commun Psychiatry., 34 (1983), pp. 72-73

[5] C.N. Bagot, R. Arya Virchow and his triad: a question of attribution. Br J Haematol., 143 (2008), pp. 180-190

[6] American Psychiatric Association Committee on Electroconvulsive Therapy. The practice of electroconvulsive therapy: recommendations for treatment, training, and privileging. 2nd ed. Washington (DC): American Psychiatric Association; 2001. 10.1176/appi.ajp.159.2.331.

[7] G.H. Utter, T.S. Dhillon, E.S. Salcedo, et al. Therapeutic Anticoagulation for Isolated Calf Deep Vein Thrombosis JAMA Surg., 151 (2016), p. e161770

[8] S. Hassan, F.N. Sheikh, S. Jamal, et al. Coronavirus (COVID-19): A Review of Clinical Features Diagnosis, and Treatment. Cureus., 12 (2020), p. e7355

[9] C. Kearon Natural history of venous thromboembolism Circulation., 107 (2003), pp. 122-130

[10] F. Zhou, T. Yu, R. Du, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study Lancet., 395 (2020), pp. 1054-1062

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