The Burden of Hypercoagulability in COVID-19

A 44-year-old male with a history of deep venous thrombosis (DVT) and pulmonary embolism (PE) with the inferior vena cava (IVC) filter in place and peripheral vascular disease (PVD) status post lower extremity vascular stenting presented from a COVID-19 rehabilitation center with bilateral phlegmasia cerulea dolens and no palpable popliteal or dorsalis pedis pulses, at risk for venous gangrene and loss of limbs. The patient was anticoagulated and taken emergently to the operating room for vascular surgery where thrombolysis with alteplase and mechanical thrombectomy were performed. Bilateral thrombolysis infusion catheters were placed for two days. The patient had a return of arterial signals in the feet and decreasing clot burden. The patient is expected to make a full recovery.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

COVID-19-Induced Phlegmasia Cerulea Dolens

Cohen¹,

Lynch²

2023

“…Commonly, clinical conditions associated with DVT are related to these three factors, such as pregnancy, surgery, immobility, malignancy, obesity, trauma, advancing age, and a history of DVT [ 8 ]. DVT has also been seen in association with coronavirus disease 2019 (COVID-19) and is associated with poorer outcomes on account of SARS-CoV-2 infection-related hypercoagulability [ 9 ]. Further, malignancies can similarly lead to hypercoagulability resulting in a greater risk of VTE [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Deep Venous Thrombosis and Pulmonary Embolism Secondary to Mild Traumatic Injury in an Elderly Male With No Additional Risk Factors

Sheth¹,

DeGeorge²,

George³

et al. 2022

Self Cite

Venous thromboembolism (VTE) is a significant cardiovascular disease with a relatively high incidence rate, presenting a significant clinical burden. Its effective diagnosis and treatment are critical to the proper management of patients with the condition. Though there are several risk factors associated with VTE, advanced age itself presents as particularly significant, with age-related risk alone leading to high incidences of VTE in elderly patients even in the absence of other risk factors or relevant medical history. We present such a case of an elderly male patient with limited risk factors beyond advanced age who nonetheless presented with symptoms of deep-vein thrombosis (DVT) following a mild traumatic injury, and upon further inspection, was found to have a pulmonary embolism (PE). Proper precautions taken in assessing potential PE upon initial discovery of DVT and post-diagnostic management were critical in this patient's outcome.

“…Though the current state of the COVID-19 pandemic remains far superior compared with the pre-vaccine era, emerging research on acute complications, chronic long-term adverse events, and "brain fog" associated with contracting the disease reveals the need for continued disease vigilance [4,5]. In this regard, vaccine hesitancy remains a particularly concerning public health threat.…”

Section: Discussionmentioning

confidence: 99%

Severe COVID-19 Pneumonia in an Unvaccinated Female Treated With Remdesivir

Ortega¹,

George²,

DeGeorge³

et al. 2022

Though recent developments in the management of the coronavirus disease 2019 (COVID-19) pandemic have resulted in significant progress, its continued persistence demands continued consideration both of larger scale public health factors as well as individual patient management. We present a case that provides a broad perspective across several issues within both categories, of a morbidly obese 34-year-old unvaccinated female presenting with respiratory distress secondary to COVID-19 pneumonia, managed through remdesivir therapy. Though this case presents an example of successful management, it nonetheless emphasizes the demand for a renewed focus on vaccine hesitancy and obesity as public health issues, particularly within the context of the pandemic.