|
Clinical presentation
|
Dyspnea, fever, respiratory discomfort |
Sudden dyspnea, hemoptysis, and pleuritic pain |
Dyspnea, orthopnea, paroxysmal nocturnal dyspnea, lower limb edema |
|
Associated symptoms
|
Sore throat, dry cough, nasal congestion, fatigue, anorexia, myalgias |
Cough, tachycardia, fever, anxiety, calf or thigh pain and/or swelling |
Tachycardia, tachypnea, palpitations and chest pain, abdominal discomfort |
|
Physical examinations
|
Tachycardia, respiratory effort, desaturation, rales |
Tachycardia, fatigue; can show pharyngitis and focal wheezing |
Tachypnea; calf of thigh pain and/or swelling, edema erythema, tenderness, decreased pulmonary sounds, rales |
Pulmonary rales, edema, raised jugular venous pressure, S3 gallop |
|
Imaging
|
Chest radiography
|
Consolidation and ground-glass opacities: bilateral, peripheral in lower lung zones. |
Diffuse, bilateral patchy interstitial infiltrates |
Non-specific findings or normal imaging |
Pulmonary edema, enlarged cardiac silhouette, pleural effusions |
|
Other
|
Chest CT (management) |
– |
Ventilation perfusion scintigraphy; CTPa |
Echocardiography: LVEF < 45% and hypokinesis; CMR LV dilated |
|
Laboratory findings
|
RT-PCR; lymphopenia, elevated transaminase, LDH and inflammatory markers |
RT-PCR; rapid antigen testing or immunofluorescent antibody staining tests |
Leukocytosis; increased BNP; D-dimer levels increase during the course of a normal pregnancy and slowly decline postpartum, not being used as a diagnostic tool |
Troponin slightly elevated, BNP elevated |
|
Natural course and prognosis
|
Symptoms tend to improve in < 2 weeks |
Postpartum women have an increased risk for severe complications |
The course of the disease depends on its gravity and the patient's precondition |
In most cases, left ventricular systolic function recovers to the normal range, usually withing 6 months |
|
Management
|
Symptomatic relief, supportive therapy, and social isolation |
Symptomatic relief, Oseltamivir, and supportive therapy |
Respiratory and hemodynamic support; empiric anticoagulation (depending on risk of bleeding) |
Standard treatment for heart failure with reduced ejection fraction, loop diuretic for edema control, and serial echocardiograms |
