Progressive COVID-19-Associated Coagulopathy Despite Treatment with Therapeutic Anticoagulation and Thrombolysis

Aribawa, I Gusti Ngurah Mahaalit; Hidayat, Leonard; Dewi, Putu Utami; Ryalino, Christopher

doi:10.12659/ajcr.930667

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Within the available data, in the majority of cases, a peripheral segmental/subsegmental thrombosis was recorded, but some patients also had an involvement of the main/lobar pulmonary arteries [ 40 , 42 , 45 ]. High-risk PT was described in only a few patients from different papers [ 25 , 28 , 37 , 39 , 40 , 44 , 45 , 46 ]. The localisation of PT, as a predominant segmental/subsegmental lung microthrombosis, is associated with widespread parenchymal abnormalities [ 25 , 29 ].…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

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Pulmonary Thrombosis despite Therapeutic Anticoagulation in COVID-19 Pneumonia: A Case Report and Literature Review

Niculae,

Gorea,

Tirlescu

et al. 2023

Viruses

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The rate of thrombotic complications in COVID-19 patients is high and could be associated with the risk of unfavourable outcomes. Moreover, pulmonary thrombotic events can occur even in patients already on anticoagulant treatment. We present the case of a patient with severe COVID-19 pneumonia, without traditional risk factors for thrombosis, who developed massive pulmonary thrombosis (PT) despite therapeutic anticoagulation. The diagnosis was challenging, and the case raised concerns about the protective role of conventional anticoagulant treatment in COVID-19 pneumonia. Thus, we searched for literature reports on COVID-19 patients who developed PT despite being under anticoagulation therapy. We identified 13 cohort studies including 4058 patients of which 346 (8.5%) developed PT and nine case reports/series enrolling 14 patients. Four cohorts were further analysed, which reported data on risk factors for thrombosis, outcomes and biological characteristics. We found that there were no differences between patients with and without PT regarding the classical risk factors for thrombosis. PT occurred regardless of the anticoagulation regimen, and the risk factor identified was severe COVID-19 pneumonia and a stay in an intensive care unit (ICU). Pulmonary thrombotic events in patients with COVID-19 are rather inflammation-related than correlated with traditional thromboembolic risk factors, and the therapeutic approach must take into consideration this aspect.

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…Pulmonary thrombotic risk factors in patients with COVID-19 are rather inflammation-related (including severe/critical COVID-19) than traditional thromboembolic risk factors [ 37 , 38 , 39 , 40 , 43 , 44 , 45 ].…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%