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Thromb J . Right atrial thrombus and pulmonary embolism in a young adult with COVID‑19 and tuberculosis coinfection: a case report

tetano

Editor, Senior Moderator
Thromb J


. 2025 Oct 21;23(1):99.
doi: 10.1186/s12959-025-00796-8. Right atrial thrombus and pulmonary embolism in a young adult with COVID‑19 and tuberculosis coinfection: a case report

Maryam Nasiri[SUP] 1 [/SUP], Shirin Shakibaei[SUP] 2 [/SUP], Sam Zeraatiannejaddavani[SUP] 3 [/SUP]



Affiliations
Abstract

Background: Coronavirus Disease 2019 (COVID-19) has been linked to thromboembolic complications, especially in severely ill patients. Intracardiac thrombi are uncommon and pose a very high risk. Coinfection with tuberculosis (TB) may worsen the prothrombotic state and complicate treatment. A 21-year-old male patient from Afghanistan developed active pulmonary tuberculosis (TB) and COVID-19. He had a large, mobile thrombus in the right atrium and an acute pulmonary embolism (PE), but no deep vein thrombosis (DVT). He received remdesivir, anti-TB medication, anticoagulation, and underwent a successful surgical embolectomy. At a nine-month follow-up, he remained symptom-free.
Conclusion: This case highlights the rare occurrence of a right atrial thrombus in COVID-19, possibly exacerbated by TB co-infection. Early detection and tailored treatment, including surgery, are crucial to lowering mortality in these high-risk patients, but further research is needed to establish optimal management strategies and confirm the role of TB in thrombotic complications.

Keywords: Cardiac surgery; Coronavirus disease 2019; Hypercoagulability; Pulmonary embolism; Right atrial thrombus; Tuberculosis.

 
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