ISSN: 1859 - 2872
Case report: Acute pulmonary embolism in a severe COVID-19 patient successfully treated with fibrinolysis
Main Article Content
Keywords
Abstract
Systemic hypercoagulability is a characteristic of COVID-19. Critically ill COVID-19 patients have a high risk of thromboembolism, especially pulmonary embolism (PE), which is nine times higher than non-COVID-19 patients. The mortality rate in patients with PE due to COVID-19 is twice as high as in non-COVID-19 cases. However, the diagnosis and treatment of pulmonary embolism in critically ill COVID-19 patients still face many difficulties. We report a severe COVID-19 case presenting with hypoxic acute respiratory failure, and bedside echocardiography with right-chamber thrombosis suggesting a high risk of PE. Systemic fibrinolytic therapy showed a marked improvement in respiratory and hemodynamic indices. From this case, it is suggested that fibrinolysis might be considered a rescue therapy for critically life-threatening COVID-19 patients.
Article Details
References
2. Barrett CD, Moore HB, Moore EE et al (2022) Study of alteplase for respiratory failure in SARS-CoV-2 COVID-19: A vanguard multicenter, rapidly adaptive, pragmatic, randomized controlled trial. Chest 161(3): 710-727.
3. Konstantinides SV, Meyer G, Becattini C et al (2020) 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J 41(4): 543-603.
4. Kwee RM, Adams HJA, Kwee TC (2021) Pulmonary embolism in patients with COVID-19 and value of D-dimer assessment: A meta-analysis. Eur Radiol 31(11): 8168-8186.
5. Nopp S, Moik F, Jilma B et al (2020) Risk of venous thromboembolism in patients with COVID-19: A systematic review and meta-analysis. Res Pract Thromb Haemost 4(7): 1178-1191.
6. Ortega-Paz L, Capodanno D, Montalescot G et al (2021) Coronavirus disease 2019-associated thrombosis and coagulopathy: Review of the pathophysiological characteristics and implications for antithrombotic management. J Am Heart Assoc. 10(3): 019650.
7. Price LC, Garfield B, Bleakley C et al (2020) Rescue therapy with thrombolysis in patients with severe COVID-19-associated acute respiratory distress syndrome. Pulm Circ 10(4): 2045894020973906.
8. Singhania N, Bansal S, Nimmatoori DP et al (2020) Current Overview on Hypercoagulability in COVID-19. Am J Cardiovasc Drugs 20(5): 393-403.
9. Spyropoulos AC, Levy JH, Ageno W et al (2020) Scientific and Standardization Committee communication: Clinical guidance on the diagnosis, prevention, and treatment of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost 18(8): 1859-1865.
Article Sidebar
