Case Report
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Pulmonary Embolism Developing Despite the Use of Anticoagulants in Covid-19 Pneumonia: A case report

Year 2022, Volume: 4 - Supplement 1, 160 - 163, 01.04.2022
https://doi.org/10.46310/tjim.1073686

Abstract

COVID-19 pneumonia is one of the diseases that can cause hypercoagulability. It is not uncommon to encounter arterial or venous thromboembolic events during COVID-19 infection. In this case, we wanted to discuss a case of a pulmonary embolism due to COVID-19 infection, which developed despite the usage of therapeutic dosage of anticoagulants. A 41-year-old male patient with a known diabetes mellitus was admitted to our clinic with complaints of cough and headache. The patient was found to be COVID-19 positive. Along with steroid treatment, 2x6,000 IU enoxaparin treatment was initiated for the patient. He developed sudden respiratory distress and showed an increase in oxygen demand. D-dimer value increased abruptly to 35.2 mg/L. Pulmonary CT angiography showed multiple bilateral subsegmental pulmonary embolisms. Since COVID-19 infection can cause arterial and venous thromboembolic events in patients following up with COVID-19 pneumonia, prophylactic anticoagulation should be initiated in hospitalized patients. Attention should be paid to signs of bleeding, and dose adjustment should be made by monitoring coagulation parameters.

References

  • Panigada M, Bottino N, Tagliabue P, Grasselli G, Novembrino C, Chantarangkul V, Pesenti A, Peyvandi F, Tripodi A. Hypercoagulability of COVID-19 patients in intensive care unit: A report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost. 2020 Jul;18(7):1738-42. doi: 10.1111/jth.14850.
  • Maier CL, Truong AD, Auld SC, Polly DM, Tanksley CL, Duncan A. COVID-19- associated hyperviscosity: a link between inflammation and thrombophilia? Lancet. 2020 Jun 6;395(10239):1758-9. doi: 10.1016/S0140- 6736(20)31209-5.
  • Mansory EM, Srigunapalan S, Lazo-Langner A. Venous thromboembolism in hospitalized critical and noncritical COVID-19 patients: A systematic review and meta-analysis. TH Open. 2021 Jul 6;5(3):e286-e294. doi: 10.1055/s-0041-1730967.
  • Kollias A, Kyriakoulis KG, Lagou S, Kontopantelis E, Stergiou GS, Syrigos K. Venous thromboembolism in COVID-19: A systematic review and meta-analysis. Vasc Med. 2021 Aug;26(4):415-25. doi: 10.1177/1358863X21995566.
  • Dolhnikoff M, Duarte-Neto AN, de Almeida Monteiro RA, da Silva LFF, de Oliveira EP, Saldiva PHN, Mauad T, Negri EM. Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. J Thromb Haemost. 2020 Jun;18(6):1517-9. doi: 10.1111/jth.14844.
Year 2022, Volume: 4 - Supplement 1, 160 - 163, 01.04.2022
https://doi.org/10.46310/tjim.1073686

Abstract

References

  • Panigada M, Bottino N, Tagliabue P, Grasselli G, Novembrino C, Chantarangkul V, Pesenti A, Peyvandi F, Tripodi A. Hypercoagulability of COVID-19 patients in intensive care unit: A report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost. 2020 Jul;18(7):1738-42. doi: 10.1111/jth.14850.
  • Maier CL, Truong AD, Auld SC, Polly DM, Tanksley CL, Duncan A. COVID-19- associated hyperviscosity: a link between inflammation and thrombophilia? Lancet. 2020 Jun 6;395(10239):1758-9. doi: 10.1016/S0140- 6736(20)31209-5.
  • Mansory EM, Srigunapalan S, Lazo-Langner A. Venous thromboembolism in hospitalized critical and noncritical COVID-19 patients: A systematic review and meta-analysis. TH Open. 2021 Jul 6;5(3):e286-e294. doi: 10.1055/s-0041-1730967.
  • Kollias A, Kyriakoulis KG, Lagou S, Kontopantelis E, Stergiou GS, Syrigos K. Venous thromboembolism in COVID-19: A systematic review and meta-analysis. Vasc Med. 2021 Aug;26(4):415-25. doi: 10.1177/1358863X21995566.
  • Dolhnikoff M, Duarte-Neto AN, de Almeida Monteiro RA, da Silva LFF, de Oliveira EP, Saldiva PHN, Mauad T, Negri EM. Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. J Thromb Haemost. 2020 Jun;18(6):1517-9. doi: 10.1111/jth.14844.
There are 5 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Case Reports
Authors

İffet Beril Gökmen 0000-0003-4986-200X

Sidelya Ecem Yiğit 0000-0002-9961-4066

Yıldız Okuturlar 0000-0002-1994-0014

İftihar Köksal 0000-0003-4892-8935

Publication Date April 1, 2022
Submission Date February 15, 2022
Acceptance Date March 9, 2022
Published in Issue Year 2022 Volume: 4 - Supplement 1

Cite

EndNote Gökmen İB, Yiğit SE, Okuturlar Y, Köksal İ (April 1, 2022) Pulmonary Embolism Developing Despite the Use of Anticoagulants in Covid-19 Pneumonia: A case report. Turkish Journal of Internal Medicine 4 160–163.

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