PMC7688468_01
High-resolution computed tomography (HRCT) of the lungs in COVID-19 child showing bilateral multiple patchy areas of ground glass opacities.
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F1
C-reactive protein (CRP) 38 mg/dL (reference range: up to 6), erythrocyte sedimentation rate (ESR) 38 mm/h (reference range: up to 20), and lactate dehydrogenase (LDH) 427 U/L (reference range: 140-280). Chest x-ray and high-resolution computed tomography (HRCT) showed typical ground-glass opacitiesin both lungs, suggesting viral pneumonia (Figure 1).
Transthoracic echocardiogram showing a large 2.5 x 1.5 cm mass on tricuspid valve leaflet protruded to the right atrium and right ventricle.
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F2
Because of persistent fever and tachycardia, pediatric cardiology consultation was requested and transthoracic echocardiography revealed a large mobile homogenous mass (2.5 x 1.5 cm) on the tricuspid valve leaflet extended to the RA and right ventricle (RV) with attachment to the tip of central venous catheter (CVC) that was in favor of thrombus or vegetation (Figure 2).
Formation of a large thrombus around the CVC that was removed along with catheter via open heart surgery.
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F3
CVC while cardiac valves were preserved (Figure 3). After the surgery, he was admitted to the ICU, and the pediatric ward thereafter. Culture result of the thrombus showed no fungal and bacterial infection and also SARS-CoV-2 RNA was not detected in the mass.