Fig. 4

A female patient 48 years old known case of COVID-19 infection as confirmed by PCR. She complained of chest pain 12 days after the onset of the disease and her oxygen saturation level showed a gradual decrease. Her D-dimer level was 1.1 μg/ml and repeated to show a gradual increase reaching 1.8 μg/ml. a The axial CT image of the baseline study of the patient showing a few bilateral peripheral patchy areas of ground-glass opacity while b was her follow-up after a recent complaint showing a progressive course of the disease extension. A pulmonary embolism was suspected for which CTPA was done and revealed a saddle pulmonary embolism involving the right and left main pulmonary arteries extending into the lobar branches (white arrow in image d and e). Positive RV strain was identified with dilated main pulmonary artery (31.9 mm in image c), reversed RV/LV ratio, and leftward deviation of the IV septum (image e)