A Case Report of Bilateral Renal and Splenic Infarcts in Severe Covid-19 While on Prophylactic Heparin

LIVITZ, B.; MILETIC, N.; GO, R.

doi:10.1016/j.chest.2021.12.199

Chest

2022

DOI: 10.1016/j.chest.2021.12.199

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A Case Report of Bilateral Renal and Splenic Infarcts in Severe Covid-19 While on Prophylactic Heparin

B. LIVITZ¹,

N. MILETIC²,

R. GO³

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Dexamethasone/methylprednisolone

2022

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Off label use and lack of efficacy: case reportA 59-year-old man received off label treatment with dexamethasone and methylprednisolone for COVID-19. Additionally, he exhibited lack of efficacy during the treatment with methylprednisolone for splenic and renal infarction with thrombosis [routes not stated].The man, who had eight day history of cough, fever, anosmia and progressive dyspnoea, presented with severe COVID-19 pneumonia. Oxygen was started via nasal cannula. Chest radiography revealed bilateral opacities. Laboratory findings were significant for CRP 10 mg/dL, ferritin 2289 ng/mL and D-dimer 0.97 mg/dL. He received an off-label treatment with dexamethasone 6mg and methylprednisolone [Solumedrol] 1g daily along with remdesivir and enoxaparin [enoxaparin-sodium]. After five days, he developed severe left sided abdominal and flank pain. Subsequent CT scan of pelvis and abdomen revealed splenic and bilateral renal infarcts with thrombosis. D-dimer was 4.46 mg/dL.Despite increasing methylprednisolone splenic and renal infarct with thrombosis did not stop. Subsequently, the man was treated with heparin and dexamethasone. After five days, his oxygen requirements improved to room air. Thereafter, he was discharged with apixaban for three months.

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Dexamethasone/methylprednisolone

2022

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A Case Report of Bilateral Renal and Splenic Infarcts in Severe Covid-19 While on Prophylactic Heparin

Cited by 1 publication

References 0 publications

Dexamethasone/methylprednisolone

Dexamethasone/methylprednisolone

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