PACEMAKER LEAD-ASSOCIATED PULMONARY EMBOLISM IN PATIENT WITH COVID- 19 INFECTION

Coronavirus disease is a novel severe acute respiratory syndrome, caused by RNA corona virus (SARS-CoV-2) originating from Wuhan, China, and with the development of global pandemic state. It was declared a pandemic in February of 2020 by the World Health Organization's Director-General, dubbing it COVID-19. Mounting cases and deaths pose a major challenge for health care systems all over the globe There have been several reported cases, confirming that COVID-19 is associated with abnormal coagulation parameters and hypercoagulable state with increased risk of both venous and arterial thromboembolism. Some of the other conditions that are associated with higher risks for developing thromboembolic disease include diabetes mellitus, obesity, metabolic disease, use of oral glucocorticoids, and cardiac implantable electronic devices. This case describes clinical deterioration in a patient, who developed pulmonary embolism with pacemaker lead-associated thrombus complicated by acute right-sided heart failure 2.5 months after COVID-19 infection. With presentation of this clinical case we emphasize that in management of post-covid patients, it is highly essential to evaluate other possible hypercoagulable states and to provide personalized thromboprophylaxis strategies. Our case highlights the importance of long-term anticoagulation therapy in comorbid high-risk patients with device lead in cardiac chambers.