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The currently pandemic coronavirus (SARS-Coronavirus-2 : SARS-CoV-2) is known to have delayed exacerbation of symptoms and emergence of complications, with the mechanisms possibly immune-mediated. Her...e, we report a mild Coronavirus disease 2019 (COVID-19) case complicated with pulmonary embolism (PE) and deep vein thrombosis (DVT). The 38-year-old male patient had fever, cough, and dyspnea on day 1 and was diagnosed with COVID-19 because specific SARS-CoV-2 RNA was positive in a nasopharyngeal swab taken on day 2. Symptoms resolved without oxygenation or specific treatment, but eruptions on his limbs appeared on day 9 and right calf pain began on day 10. Computed tomography revealed PE and DVT. The eruptions disappeared naturally, and the calf pain improved after administration of rivaroxaban. Specific SARS-CoV-2 RNA was negative on days 13 and 15. IgG and IgM measured using residual serum showed that the emergence of complications coincided with viral clearance and IgG seroconversion. The clinical course of our patient supports the theory that some COVID-19 complications are induced by host immunity.
新型コロナウイルス感染症（COVID-19）は，症状増悪や合併症が発症から遅れて出現することが知られており，そのメカニズムは自己免疫が介在している可能性が報告されている．ここに，軽症のCOVID-19に肺塞栓症（PE）と深部静脈血栓症（DVT）を合併した症例を報告する．38歳の生来健康な男性患者が，day 1に発熱，咳嗽，呼吸困難を呈し，day 2に採取した鼻咽頭スワブによるPCRで新型コロナウイルス（SARS-CoV-2）RNAが陽性であったため，COVID-19と診断された．酸素投与や特異的治療を要することなく自然解熱したものの，day 9に四肢に発疹が出現し，day 10に右腓腹部の疼痛を認めた．造影CTにてPEとDVTが確認された．発疹は自然消失し，腓腹部痛はrivaroxaban投与後に改善した．day 13，15 にPCR 陰性化を確認した．残存血清を用いて血清IgGとIgMを測定したところ，合併症の出現時期はウイルスクリアランスとIgG seroconversionと一致した．本患者の臨床経過は，COVID-19の合併症の中には宿主免疫によって引き起こされるものがあるという仮説を支持するものであった．show more
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