Large saddle pulmonary embolism in a woman infected by COVID-19 pneumonia

Jafari, Ramezan; Cegolon﻿﻿, Luca; Jafari, Alireza; Kashaki, Mandana; Otoukesh, Babak; Ghahderijani, Bahareh Heshmat; Izadi, Morteza; Saadat, Seyed Hassan; Einollahi, Behzad; Javanbakht, Mohammad

doi:10.1093/eurheartj/ehaa402

Cited by 12 publications

(15 citation statements)

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“…To date, a few case series studies (12)(13)(14)(15)(16)(17)(18)(19) and some case reports (17,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) have investigated the incidence and features of pulmonary thrombosis or embolism (PE) in patients with Covid-19. All studies included small numbers of cases, and most of them were conducted in ICU patients (12,(16)(17)(18)(19), as they constitute a particular group with an increased risk of PE (14).…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Thrombosis or Embolism in a Large Cohort of Hospitalized Patients With Covid-19

et al. 2020

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Objective: We set out to analyze the incidence and predictive factors of pulmonary embolism (PE) in hospitalized patients with Covid-19. Methods: We prospectively collected data from all consecutive patients with laboratory-confirmed Covid-19 admitted to the Hospital de la Santa Creu i Sant Pau, a university hospital in Barcelona, between March 9 and April 15, 2020. Patients with suspected PE, according to standardized guidelines, underwent CT pulmonary angiography (CTPA). Results: A total of 1,275 patients with Covid-19 were admitted to hospital. CTPA was performed on 76 inpatients, and a diagnosis of PE was made in 32 (2.6% [95%CI 1.7-3.5%]). Patients with PE were older, and they exhibited lower PaO 2 :FiO 2 ratios and higher levels of D-dimer and C-reactive protein (CRP). They more often required admission to ICU and mechanical ventilation, and they often had longer hospital stays, although in-hospital mortality was no greater than in patients without PE. High CRP and D-dimer levels at admission (≥150 mg/L and ≥1,000 ng/ml, respectively) and a peak D-dimer ≥6,000 ng/ml during hospital stay were independent factors associated with PE. Prophylactic low molecular weight heparin did not appear to prevent PE. Increased CRP levels correlated with increased D-dimer levels and both correlated with a lower PaO 2 :FiO 2. Conclusions: The 2.6% incidence of PE in Covid-19 hospitalized patients is clearly high. Higher doses of thromboprophylaxis may be required to prevent PE, particularly in patients at increased risk, such as those with high levels of CRP and D-dimer at admission. These findings should be validated in future studies.

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Section: Introductionmentioning

confidence: 99%

Pulmonary Thrombosis or Embolism in a Large Cohort of Hospitalized Patients With Covid-19

et al. 2020

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“…I nformation regarding the imaging manifestations in patients infected with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has been rapidly evolving; however, most of the imaging studies have primarily focused on the pulmonary, gastrointestinal, and cardiac manifestations of coronavirus disease 2019 (COVID-19). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Emerging case reports have described neuroimaging manifestations seen in patients with COVID-19 infection, including acute intracranial hemorrhage, demyelinating lesions, and encephalitis. 16 The presence of paraspinal muscular pathology in the setting of COVID-19 infection has not been previously reported.…”

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confidence: 99%

Paraspinal Myositis in Patients with COVID-19 Infection

Mehan

Yoon

Lang

et al. 2020

AJNR Am J Neuroradiol

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Myalgia is a previously reported symptom in patients with COVID-19 infection; however, the presence of paraspinal myositis has not been previously reported. We report MR imaging findings of the spine obtained in a cohort of 9 patients with COVID-19 infection who presented to our hospital between March 3, 2020 and May 6, 2020. We found that 7 of 9 COVID-19 patients (78%) who underwent MR imaging of the spine had MR imaging evidence of paraspinal myositis, characterized by intramuscular edema and/or enhancement. Five of these 7 patients had a prolonged hospital course (greater than 25 days). Our knowledge of the imaging manifestations of COVID-19 infection is expanding. It is important for clini-cians>a to be aware of the relatively high frequency of paraspinal myositis in this small cohort of patients with COVID-19 infection.

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“…12 Fenômenos tromboembólicos pulmonares desempenham importante papel no processo de falência cardíaca direita. 13 E, mais raramente, pericardite.…”

Section: Patogenia Achados Histopatológicos E Macroscópicos Cardíacosunclassified

“…Geralmente, a evolução da COVID-19 guarda relação com a idade 14 e comorbidades presentes.1 [5][6][7][8][9][10][11][12][13][14][15][16][17][18] Habitualmente, alterações cardíacas são vistas nos casos de acometimento pulmonar mais grave em pacientes internados na UTI e principalmente naqueles que necessitam de suporte de ventilação invasiva. 19 Arritmias cardíacas têm importante papel, 20,21 principalmente a fibrilação atrial.…”

Section: Apresentação Clínicaunclassified

COVID-19 e o Coração

Feitosa¹,

Andrade²,

Pereira³

et al. 2020

RCHSI

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A pandemia por SARS-CoV-2 traz graves consequências para o aparelho respiratório que se agrava quando há concomitante envolvimento cardíaco, o que não raramente ocorre, principalmente em pacientes internados. As alterações cardíacas são caracterizadas por reações inflamatórias sistêmicas, hipóxia generalizada, tromboses de coronárias epicárdicas ou de pequenos vasos, infecção viral do miocárdio, ou hipertensão pulmonar aguda como resultado do embolismo pulmonar ou trombose local. A lesão miocárdica medida pela elevação de troponina é ominosa. Achados de imagem, principalmente ecocardiograma à beira do leito, assim como a cineangiocoronariografia e a ressonância magnética cardíaca têm sido de grande utilidade para o reconhecimento da lesão. Assim como, arritmias, infarto do miocárdio, insuficiência cardíaca e choque são manifestações principais de envolvimento cardíaco. Nos casos leves a moderados, as medicações prévias, principalmente os inibidores da enzima de conversão da angiotensina (IECA), bloqueadores de receptores de angiotensina (BRA), estatinas e outros correlatos devem ser mantidos. Nos casos graves a atenção se volta para o uso de drogas vasoativas potentes. Uma atenção especial se volta para os cuidados de pacientes que precisam de atendimento pelas manifestações cardiológicas, principalmente o infarto agudo do miocárdio e a insuficiência cardíaca, nesse momento de receio de contaminação hospitalar. Os Serviços têm providenciado ao máximo as medidas de proteção com fluxo distinto para esses pacientes. Após a COVID-19, o retorno às atividades mais exigentes deve ser precedido de cuidadosa avaliação médica para orientações sobre possíveis sequelas.

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Large saddle pulmonary embolism in a woman infected by COVID-19 pneumonia

Cited by 12 publications

References 0 publications

Pulmonary Thrombosis or Embolism in a Large Cohort of Hospitalized Patients With Covid-19

Pulmonary Thrombosis or Embolism in a Large Cohort of Hospitalized Patients With Covid-19

Paraspinal Myositis in Patients with COVID-19 Infection

COVID-19 e o Coração

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