Epistaxis in hospitalized patients with COVID-19

Dell’Era, Valeria; Dosdegani, R; Valletti, Paolo Aluffi; Garzaro, Massimiliano

doi:10.1177/0300060520951040

Cited by 11 publications

(11 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We postulate that the extensive epistaxis in both of our cases was triggered by the administration of IV-rtPA, in the setting of other risk factors such as COVID-19 invading the nasal mucosa, resulting in erosion of the endothelium, trauma to the nasal mucosa from sneezing, or dry air from the nasal cannula irritating the mucosa. [ 11 ]…”

Section: Discussionmentioning

confidence: 99%

Severe Epistaxis after Tissue Plasminogen Activator administration for Acute Ischemic Stroke in SARS-COV-2 Infection

et al. 2021

View full text Add to dashboard Cite

Patients with COVID-19 may suffer from hemorrhagic complications. Our article highlights two cases of COVID-19-infected patients, who suffered severe epistaxis after initiation of intravenous recombinant tissue plasminogen activator (IV-rtPA) for acute ischemic stroke, followed by a sudden decline in their clinical status and ultimately leading to death within days. Given the global impact and mortality of COVID-19, it is essential to be aware of its unusual presentation and improve therapeutic strategies. We present two cases of individuals who suffered from a large vessel occlusion of and were candidates for both IV-rtPA and mechanical thrombectomy. They received IV-rtPA but had epistaxis so severe that they were not able to receive MT and died within the next few days. There are many potential mechanisms by which epistaxis can happen in an individual with COVID-19 who received IV-rtPA including invasion of the nasal mucosa and endothelium through angiotensin-converting enzyme 2 receptors by the virus. We also hypothesize that the coagulation abnormality seen in COVID-19 patients can be potentiated by the use of treatments such as IV-rtPA. We review these issues with a diagram illustrating the possible mechanisms.

show abstract

Section: Discussionmentioning

confidence: 99%

Severe Epistaxis after Tissue Plasminogen Activator administration for Acute Ischemic Stroke in SARS-COV-2 Infection

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In a case series of 104 hospitalized COVID-19 patients, Dell'Era et al 5 observed that 30 patients developed spontaneous epistaxis. These patients were at increased risk due to components of standard care including use of nasal cannula or continuous positive airway pressure and low molecular weight heparin.…”

Section: Identifying the Cause Of Epistaxismentioning

confidence: 99%

“…These patients were at increased risk due to components of standard care including use of nasal cannula or continuous positive airway pressure and low molecular weight heparin. They suggested the use of nasal lubricant that prevents crust formation and avoids nosebleed 5 .…”

Section: Identifying the Cause Of Epistaxismentioning

confidence: 99%

Management of epistaxis during COVID-19 pandemic

Mishra¹,

Sahoo

Gosain

2021

Romanian Journal of Rhinology

View full text Add to dashboard Cite

Epistaxis represents a commonly encountered manifestation in the ENT Emergency Department. Healthcare providers working in the ENT Emergency Department are at high risk of COVID-19 infection both because of the high viral load in the upper airways and because of the asymptomatic presentation of COVID-19 disease. Special focus is needed for managing the balance between appropriate patient care and ensuring the safety of healthcare workers. Adequate preparation and modification of the procedures for bleeding control to minimize risk of spread is necessary. While managing, attention should be kept on less invasive methods with avoidance of aerosol-generating activities. Nonetheless, proper use and disposal of personal protective equipment is of utmost importance in stopping the spread of COVID-19.

show abstract

“…Hence this study proposed the significance of usage of nasal lubricant and switching to humidified oxygen therapy to reduce the risk of epistaxis in the susceptible patients. (16) Since management of epistaxis is an aerosolgenerating procedure and puts the ENT specialist at risk of acquiring infection, it is best to develop strategies to prevent the occurrence of epistaxis.…”

Section: Ent Manifestations Of Covid-19mentioning

confidence: 99%

ENT Manifestations of COVID – 19: A Retrospective study

Prahlada¹,

Kamath²

2021

IJPCCR

View full text Add to dashboard Cite

The novel COVID-19 infection was the cause of worldwide morbidity and mortality. From an otorhinolaryngologist perspective, high index of suspicion for coronavirus infection is needed while encountering certain clinical presentations in OPD settings. This enables early detection and prompt treatment of affected individuals. To detect, analyse and discuss the different ear, nose, throat and laryngeal (ENT manifestations) reported in RT-PCR COVID-19 Positive patients at Basaveshvara Medical College and Hospital, Chitradurga. A retrospective observational cohort study carried out at Basaveshvara Medical College and Hospital, Chitradurga Karnataka from September 16, 2020 to October 31, 2020. Using a standard, predesigned questionnaire, clinical data was collected from these patients by telephone-based interview. Out of 420 patients diagnosed with Covid-19 infection, 55.9% presented with some ENT manifestation. Majority were male(n=165) and female were less common(n=70). The most common symptom was cough (50.21%), followed by sore throat (38.29%), odynophagia (34.04%), smell disorders (26.38%), taste disorders (20.85%), headache (8.93%), nasal obstruction (6.80%), rhinorrhoea (6.38%). Out of 235 patients with ENT symptoms, 111 patients had smell and/or taste disturbances. During pandemic, clinical diagnosis is an important tool for early diagnosis of asymptomatic or pre-symptomatic suspected Covid-19 patients when diagnostic tests are not available and/or unpredictable. There is scope for further research in development of rapid screening tools for detecting coronavirus infection based on highly suspicious ENT symptoms.

show abstract

Epistaxis in hospitalized patients with COVID-19

Cited by 11 publications

References 7 publications

Severe Epistaxis after Tissue Plasminogen Activator administration for Acute Ischemic Stroke in SARS-COV-2 Infection

Severe Epistaxis after Tissue Plasminogen Activator administration for Acute Ischemic Stroke in SARS-COV-2 Infection

Management of epistaxis during COVID-19 pandemic

ENT Manifestations of COVID – 19: A Retrospective study

Contact Info

Product

Resources

About