Rectus Sheath Hematoma in COVID-19 Patients as a Mortal Complication: A Retrospective Report

Background Rectus sheath hematoma is a rare self-limited presentation that has become a concern in hospitalized COVID-19 patients receiving anticoagulant therapies. Method A retrospective multicentric study was conducted in referral hospitals affiliated with the Tehran University of Medical Science, Tehran, Iran, between June and August 2021. Patients with a confirmed diagnosis of COVID-19 that were complicated with rectus sheath hematoma during hospitalization were included. Median (lower quartile to upper quartile) was used to report the distribution of the results. Result This study was conducted on nine patients with confirmed COVID-19 pneumonia, including eight females and one male. The severity of viral pneumonia was above average in eight patients. The median age and median body mass index were 65 (55.5 to 78) years and 29.38 (23.97 to 31.71) kg/m2. The duration of anticoagulant therapy was 10 (6 to 14) days, and the median length of hospital stay was 20 (10 to 23.5) days. Rectus sheath hematoma occurred after a median reduction of 4 (2.7 to 6.6) units in blood hemoglobin. Although 66.7% received ICU care and all of them were under full observation in well-equipped hospitals, the mortality rate was 55.6%. Conclusion In summary, increased levels of inflammatory markers such as lactic acid dehydrogenase along with an abrupt decrease in blood hemoglobin in COVID-19 patients should be considered as predisposing factors for rectus sheath hematoma, especially in patients with moderate to severe COVID-19 pneumonia under anticoagulant therapy. This complication had been considered a self-limited condition;however, it seems to be fatal in patients with COVID-19 pneumonia. Further studies in larger sample sizes should be conducted to find out suitable management for this complication.

Rectus Sheath Hematoma in COVID-19 Patients as a Mortal Complication: A Retrospective Report.

Background: Rectus sheath hematoma is a rare self-limited presentation that has become a concern in hospitalized COVID-19 patients receiving anticoagulant therapies. Method: A retrospective multicentric study was conducted in referral hospitals affiliated with the Tehran University of Medical Science, Tehran, Iran, between June and August 2021. Patients with a confirmed diagnosis of COVID-19 that were complicated with rectus sheath hematoma during hospitalization were included. Median (lower quartile to upper quartile) was used to report the distribution of the results. Result: This study was conducted on nine patients with confirmed COVID-19 pneumonia, including eight females and one male. The severity of viral pneumonia was above average in eight patients. The median age and median body mass index were 65 (55.5 to 78) years and 29.38 (23.97 to 31.71) kg/m2. The duration of anticoagulant therapy was 10 (6 to 14) days, and the median length of hospital stay was 20 (10 to 23.5) days. Rectus sheath hematoma occurred after a median reduction of 4 (2.7 to 6.6) units in blood hemoglobin. Although 66.7% received ICU care and all of them were under full observation in well-equipped hospitals, the mortality rate was 55.6%. Conclusion: In summary, increased levels of inflammatory markers such as lactic acid dehydrogenase along with an abrupt decrease in blood hemoglobin in COVID-19 patients should be considered as predisposing factors for rectus sheath hematoma, especially in patients with moderate to severe COVID-19 pneumonia under anticoagulant therapy. This complication had been considered a self-limited condition; however, it seems to be fatal in patients with COVID-19 pneumonia. Further studies in larger sample sizes should be conducted to find out suitable management for this complication.

Did Iranians respect health measures during Nowruz holidays? A study on Iranians' knowledge, attitude and practice toward COVID-19.

INTRODUCTION: Since December 2019, the COVID-19 outbreak has affected almost every country in the world, including Iran. General awareness and commitment to recommendations made by health officials have important role in control of the outbreak. The aim of the current study was to assess the knowledge, attitude, and practice (KAP) of Iranians concerning COVID-19 after Nowruz (Persian New Year Holiday) in Iran and identifying its determining demographic and socioeconomic factors. METHOD: A cross-sectional study was designed. We translated and culturally adopted Zhong's questionnaire to Persian, which is designed to assess people's knowledge, attitude, and practice toward COVID-19. We used online Google forms to send the questionnaire via social platforms throughout the country. A total of 1015 Iranians participated in the study. RESULTS: The mean knowledge score among our participants was 10.60, with an overall correct response rate of 88.35%. Higher knowledge score was associated with higher education, being a professor, and residing in cities. Lower knowledge score was associated with being unemployed, marital status other than single or married, and living in rural areas. Almost all of our participants had favorable attitudes and practices toward COVID-19. CONCLUSION: Overall, Iranians showed a satisfactory KAP towards COVID-19. We suggest more attention to informing people living in rural areas and unemployed, as they were related to more risky behaviors and had lower knowledge scores regarding COVID-19.