Hemorrhagic complications in COVID-19: three women with pectoral hematoma and a review

Abstract

Patients hospitalized with COVID-19 pneumonia are at risk for thrombotic complications. At the same time, they need respiratory support, and they frequently require nursing in a prone position. From March to May 2020, 57 patients with acute respiratory distress syndrome were admitted to our departments. Our therapeutic protocol included anticoagulant treatment and prone positioning. We have treated three obese women affected by severe pneumonia and pectoral hematoma with post-hemorrhagic anemia. We have already described two of these cases in our previous publication; in this new article, we describe a third similar case and review clinical reports from 2020 to 2022 about hemorrhagic complications during COVID-19. Reports confirm that pectoral hematomas and bleeding in unusual sites are a complication of COVID-19. Pectoral hematomas are likely to be related to COVID-19 severity, heparin dosage, and traumatism due to cough and pronosupination.