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1.
J Investig Med High Impact Case Rep ; 10: 23247096221084513, 2022.
Article in English | MEDLINE | ID: covidwho-1753092

ABSTRACT

The 2019 coronavirus disease (COVID-19) can present with a wide variety of clinical manifestations, including a hypercoagulable state leading to both arterial and venous thrombosis. Portal vein thrombosis (PVT) in the setting of COVID-19 has rarely been reported in the medical literature. Pylephlebitis with concomitant liver abscess is a rare complication of intra-abdominal infection. Here, we present the case of a 49-year-old man who initially presented with intermittent fevers and generalized weakness of 1-month duration and was subsequently found to have COVID-19 infection, PVT, and Bacteroides fragilis bacteremia with associated pyogenic liver abscess. The patient was treated with intravenous antibiotics and oral anticoagulation with plan to follow up outpatient with gastroenterology in 3 months to ensure resolution of PVT and liver abscess.


Subject(s)
Bacteremia , COVID-19 , Liver Abscess, Pyogenic , Venous Thrombosis , Bacteremia/complications , Bacteremia/drug therapy , Bacteroides , COVID-19/complications , Humans , Liver Abscess, Pyogenic/complications , Liver Abscess, Pyogenic/diagnosis , Liver Abscess, Pyogenic/drug therapy , Male , Middle Aged , Portal Vein , Venous Thrombosis/complications , Venous Thrombosis/drug therapy
2.
Public Health ; 207: 14-18, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1740128

ABSTRACT

OBJECTIVES: Vaccination is one of the most effective measures to combat the COVID-19 pandemic. The main reason for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination hesitancy is the potential side-effects. This study aimed to investigate the incidence of venous thrombosis and pulmonary embolism in patients who received SARS-CoV-2 vaccination. STUDY DESIGN: This was a retrospective cohort study. METHODS: Individuals aged ≥18 years who received an initial vaccination for COVID-19 in one of 1134 general practices in Germany between April and June 2021 were included in the study. Vaccinated patients were matched to unvaccinated individuals by age, sex, index month (April to June 2020 [unvaccinated cohort] or April to June 2021 [vaccinated cohort]) and diagnoses that may be associated with an increased incidence of thrombosis documented within 12 months before the index date. The incidences of thrombosis and non-fatal pulmonary embolism as a function of COVID-19 vaccination were analysed. RESULTS: The present study included 326,833 individuals who were vaccinated against COVID-19 and 326,833 matched unvaccinated individuals. During the follow-up period, 406 vaccinated patients and 342 individuals in the control group received a diagnosis of thrombosis or non-fatal pulmonary embolism. This resulted in an incidence rate of 11.9 vs 11.3 cases per 1000 patient-years for vaccinated vs unvaccinated individuals, respectively, and a non-significant overall incidence rate ratio (IRR: 1.06; 95% confidence interval [CI]: 0.93-1.22). The highest IRR was observed in the 41-60 years age group (IRR: 1.30; 95% CI: 0.98-1.73), and the lowest IRR was seen in the 18-40 years age group (IRR: 0.6; 95% CI: 0.0-1.05); however, none of the individual age group incidence rates was significant. CONCLUSIONS: The results indicate that the occurrence of thrombosis or pulmonary embolism after COVID-19 vaccination is a coincidental finding rather than a consequence of vaccination.


Subject(s)
COVID-19 , Pulmonary Embolism , Thrombosis , Venous Thrombosis , Adolescent , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Germany/epidemiology , Humans , Incidence , Pandemics/prevention & control , Pulmonary Embolism/complications , Pulmonary Embolism/etiology , Retrospective Studies , SARS-CoV-2 , Thrombosis/complications , Thrombosis/epidemiology , Vaccination/adverse effects , Venous Thrombosis/complications , Venous Thrombosis/etiology
3.
Stroke ; 53(6): 1892-1903, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1731382

ABSTRACT

BACKGROUND: Cerebral venous thrombosis (CVT) has recently been reported as a common thrombotic manifestation in association with vaccine-induced thrombotic thrombocytopenia, a syndrome that mimics heparin-induced thrombocytopenia (HIT) and occurs after vaccination with adenovirus-based SARS-CoV-2 vaccines. We aimed to systematically review the incidence, clinical features, and prognosis of CVT occurring in patients with HIT. METHODS: The study protocol was registered with PROSPERO (CRD42021249652). MEDLINE, EMBASE and Cochrane CENTRAL were searched up to June 1, 2021 for HIT case series including >20 patients, or any report of HIT-related CVT. Demographic, neuroradiological, clinical, and mortality data were retrieved. Meta-analysis of proportions with random-effect modeling was used to derive rate of CVT in HIT and in-hospital mortality. Pooled estimates were compared with those for CVT without HIT and HIT without CVT, to determine differences in mortality. RESULTS: From 19073 results, we selected 23 case series of HIT (n=1220) and 27 cases of HIT-related CVT (n=27, 71% female). CVT developed in 1.6% of 1220 patients with HIT (95% CI,1.0%-2.5%, I2=0%). Hemorrhagic brain lesions occurred in 81.8% of cases of HIT-related CVT and other concomitant thrombosis affecting other vascular territory was reported in 47.8% of cases. In-hospital mortality was 33.3%. HIT-related CVT carried a 29% absolute increase in mortality rate compared with historical CVT controls (33.3% versus 4.3%, P<0.001) and a 17.4% excess mortality compared with HIT without CVT (33.3% versus 15.9%, P=0.046). CONCLUSIONS: CVT is a rare thrombotic manifestation in patients with HIT. HIT-related CVT has higher rates of intracerebral hemorrhage and a higher mortality risk, when compared with CVT in historical controls. The recently reported high frequency of CVT in patients with vaccine-induced thrombotic thrombocytopenia was not observed in HIT, suggesting that additional pathophysiological mechanisms besides anti-platelet factor-4 antibodies might be involved in vaccine-induced thrombotic thrombocytopenia-related CVT.


Subject(s)
COVID-19 , Intracranial Thrombosis , Thrombocytopenia , Thrombosis , Vaccines , Venous Thrombosis , COVID-19 Vaccines/adverse effects , Female , Humans , Intracranial Thrombosis/complications , Male , SARS-CoV-2 , Thrombocytopenia/chemically induced , Thrombocytopenia/complications , Thrombosis/etiology , Vaccines/adverse effects , Venous Thrombosis/complications
4.
Neonatology ; 119(2): 268-272, 2022.
Article in English | MEDLINE | ID: covidwho-1714478

ABSTRACT

A possible consequence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is the development of an exacerbated thrombophilic status, and cerebral venous thrombosis (CVT) is a rare but possible complication of SARS-CoV-2 infection reported both in adults and in children. The present case report describes the clinical course of a term neonate showing extended CVT of unclear origin, whose mother had developed SARS-CoV-2 infection during the third trimester of pregnancy. We speculate that the prothrombotic status induced by maternal SARS-CoV-2 infection may have played a pathophysiological role in the development of such severe neonatal complication. Further investigations are required to confirm such hypothesis.


Subject(s)
COVID-19 , Intracranial Thrombosis , Pregnancy Complications, Infectious , Venous Thrombosis , Adult , COVID-19/complications , Child , Family , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Intracranial Thrombosis/diagnostic imaging , Intracranial Thrombosis/etiology , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Outcome , SARS-CoV-2 , Venous Thrombosis/complications
5.
J Stroke Cerebrovasc Dis ; 31(5): 106353, 2022 May.
Article in English | MEDLINE | ID: covidwho-1712840

ABSTRACT

Stroke is a common and devastating event and the majority of cases are caused by thromboembolism from the left atrium, left ventricle or left sided valves. This case report describes a case of embolic stroke with the origin of the thrombus from the left inferior pulmonary vein. The importance of this case is twofold. Firstly, it is the fourth case report of pulmonary venous thrombosis, a very rare condition, due to COVID-19 infection and secondly, it focuses attention on the fact that the left atrium is not the most proximal address of arterial thromboembolism-the pulmonary veins are. Thus, it is proposed that a thorough assessment of the pulmonary veins should be done in all cases of arterial thromboembolism.


Subject(s)
COVID-19 , Embolic Stroke , Ischemic Stroke , Pulmonary Embolism , Pulmonary Veins , Thromboembolism , Venous Thrombosis , COVID-19/complications , Embolic Stroke/diagnostic imaging , Embolic Stroke/etiology , Humans , Pulmonary Embolism/etiology , Thromboembolism/complications , Venous Thrombosis/complications
7.
Eur Rev Med Pharmacol Sci ; 26(2): 686-694, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1675567

ABSTRACT

OBJECTIVE: COVID-19 is associated with an increased prevalence of deep venous thrombosis (DVT), mainly in the lower limbs. However, the characteristics and rheological conditions, which contribute to facilitating DVT occurrence have been poorly investigated. We aimed to report DVT characteristics, vein diameters and peak blood flow velocities (PBFV) in the common femoral veins (CFVs) of critically ill COVID-19 patients. PATIENTS AND METHODS: We conducted a prospective single-center cohort study in March-October 2020 including all consecutive mechanically ventilated COVID-19 adults. Doppler ultrasound of the lower limbs was performed systematically during the first week of hospitalization. In DVT-free patients, a second Doppler ultrasound was performed seven days later. Data are expressed as medians (interquartile ranges) or percentages. Comparisons were performed using Mann-Whiney and Wilcoxon signed-rank tests or Fischer's exact tests, as appropriate. RESULTS: Fifty-five patients [age, 63 years (56-74); female/male ratio, 0.62; body-mass index, 29 kg/m2 (26-33); hypertension, 47%; diabetes, 38%; ischemic heart disease, 11%] were included. DVT was diagnosed in 19 patients (35%) including in 5 femoral (9%), 2 popliteal (4%) and 12 below-the-knee sites (22%). CFV diameter was increased to 12.0 mm (11.0-15.0) (normal range, 9.1-12) and PBFV reduced to 11.9 cm/s (8.8-15.8) (normal range, 21.3-49.2) [right-side values]. In four patients who had ultrasound before intubation, CFV diameter increased from 12.5 mm (11.8-13.3) before to 14 mm (13.6-15.3) after intubation (p = 0.008). CONCLUSIONS: DVT in the CFV occurred in 9% of the critically ill COVID-19 patients with an overall 35%-DVT prevalence. Venous return difficulty evidenced by larger than normal CFV diameters and lower than normal PBFVs may have facilitated proximal DVT occurrence.


Subject(s)
COVID-19/pathology , Ultrasonography, Doppler , Venous Thrombosis/diagnosis , Aged , Blood Flow Velocity , COVID-19/complications , COVID-19/mortality , COVID-19/virology , Cohort Studies , Comorbidity , Critical Illness , Female , Femoral Artery/diagnostic imaging , Femoral Artery/physiology , Humans , Male , Middle Aged , Prospective Studies , Respiration, Artificial , SARS-CoV-2/isolation & purification , Survival Analysis , Venous Thrombosis/complications
8.
Ann Intern Med ; 175(4): 541-546, 2022 04.
Article in English | MEDLINE | ID: covidwho-1662825

ABSTRACT

BACKGROUND: In March 2021, several European countries suspended the use of the AZD1222 (Oxford-AstraZeneca) COVID-19 vaccine because of thromboembolic safety concerns. Reports from Norway and Germany subsequently described patients with venous thrombosis and thrombocytopenia within 5 to 16 days of vaccination. OBJECTIVE: To evaluate the risk for outcomes related to thrombosis and thrombocytopenia after AZD1222 or BNT162b2 (Pfizer-BioNTech) COVID-19 vaccination. DESIGN: Nationwide exploratory retrospective cohort study. SETTING: Danish linkable registers on vaccinations, hospitalizations, occupation, and other covariates. PARTICIPANTS: 355 209 Danish frontline personnel designated for priority COVID-19 vaccination followed from 27 December 2020 (the day of the first COVID-19 vaccination in Denmark) to 13 April 2021. MEASUREMENTS: Study outcomes were cerebral venous sinus thrombosis, splanchnic vein thrombosis, pulmonary embolism, deep venous thrombosis, arterial thrombosis, thrombocytopenia, and death. Cumulative incidences of study outcomes within 28 days of vaccination and unvaccinated risk time were compared using adjusted survival curves resulting in risk differences (RDs) at day 28 after vaccination. Adjustment for birth cohort, sex, calendar period, occupation, comorbid conditions, and prescription drug use was included. RESULTS: Vaccination with AZD1222 versus no vaccination was associated with a significant RD at day 28 for deep venous thrombosis (RD, 8.35 [95% CI, 0.21 to 16.49] per 100 000 vaccinations). The RDs for cerebral venous sinus thrombosis (RD, 1.68 [CI, -0.64 to 4.00] per 100 000 vaccinations) and thrombocytopenia (RD, 2.39 [CI, -1.09 to 5.87] per 100 000 vaccinations) were not significant. No adverse associations were seen for BNT162b2 vaccination. LIMITATION: No medical record review; surveillance bias. CONCLUSION: In this exploratory retrospective cohort study among frontline personnel in Denmark, receipt of the AZD1222 vaccine was associated with a small excess risk for deep venous thrombosis. Although the corresponding risks for the more rare and severe thrombotic outcomes (such as cerebral venous sinus thrombosis) were not statistically significantly increased, statistical precision was low, and clinically relevant risks could not be excluded with certainty. There was no statistically significant association of BNT162b2 vaccination with thrombotic or thrombocytopenic events. PRIMARY FUNDING SOURCE: Lundbeck Foundation.


Subject(s)
COVID-19 , Sinus Thrombosis, Intracranial , Thrombocytopenia , Thromboembolism , Thrombosis , Venous Thrombosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , Occupations , Retrospective Studies , SARS-CoV-2 , Sinus Thrombosis, Intracranial/complications , Thrombocytopenia/chemically induced , Thrombocytopenia/epidemiology , Thromboembolism/epidemiology , Thromboembolism/etiology , Thrombosis/etiology , Vaccination/adverse effects , Venous Thrombosis/complications
9.
Medicine (Baltimore) ; 100(49): e28100, 2021 Dec 10.
Article in English | MEDLINE | ID: covidwho-1566097

ABSTRACT

RATIONALE: Central vein thrombosis is an uncommon cause of chylothorax, usually secondary to central venous catheterization in association with prothrombotic state causes such as malignancies. In the following case, thrombosis was located in the left brachiocephalic vein and caused recurrent chylothorax resistant to the first line of treatment and successfully treated by percutaneous recanalization using a dual approach. PATIENT CONCERNS: A 52-year-old male patient with current follicular lymphoma undergoing treatment and recent history of COVID-19 pulmonary infection was hospitalized for dyspnea. A chest X-ray revealed extensive bilateral pleural effusion. Analysis of the pleural fluid was compatible with a chylothorax. Iodin injected thoracic computed tomography (CT) revealed a complete left brachiocephalic thrombosis extending to the left axillary vein, with no thoracic mass. DIAGNOSES: Chylothorax due to left brachiocephalic vein thrombosis. INTERVENTIONS: Following an unsuccessful first line of treatment consisting of a low-fat diet, somatostatins and anticoagulation medication, the patient was elected to undergo minimally invasive venous recanalization with stenting. After a first failed attempt of recanalization by femoral access, we successfully crossed the thrombus through brachial access and conducted a dilatation and stenting of the brachiocephalic vein by femoral access, using a "telepheric" method. OUTCOMES: During the 4-month follow up, PET-scanner and chest X-ray demonstrated a significant reduction of the pleural effusion, and the patient reported complete clinical recovery. LESSONS: Central vein thrombosis is an unusual cause of chylothorax. We report a case of chylothorax complicating a brachiocephalic vein thrombosis successfully treated by percutaneous recanalization and stenting using a dual brachial and femoral approach. No thoracic duct embolization or ligature was required.


Subject(s)
Chylothorax , Stents , Venous Thrombosis , COVID-19 , Chylothorax/etiology , Chylothorax/therapy , Humans , Male , Middle Aged , Pleural Effusion , Venous Thrombosis/complications
10.
Pan Afr Med J ; 39: 273, 2021.
Article in French | MEDLINE | ID: covidwho-1472500

ABSTRACT

Acute mesenteric ischemia (AMI) is due to a sudden decrease or interruption of mesenteric blood flow resulting in inadequate blood supply to the gastrointestinal tract. This causes ischemic and inflammatory lesions often progressing to necrosis in the absence of appropriate treatment. Vascular insufficiency may arise as a result of embolism or arterial thrombosis or venous thrombosis. We here report a rare case of mesenteric venous ischemia caused by coronavirus disease 2019 (COVID-19) in a 33-year-old man in whom diagnosis was based on ultrasound and, in particular, on computed tomography (CT).


Subject(s)
COVID-19/complications , Intestines/blood supply , Mesenteric Ischemia/etiology , Tomography, X-Ray Computed/methods , Venous Thrombosis/complications , Abdominal Pain/etiology , Adult , COVID-19/diagnosis , Humans , Male , Mesenteric Ischemia/diagnostic imaging , Mesentery/blood supply , Portal Vein/diagnostic imaging , SARS-CoV-2 , Venous Thrombosis/diagnosis
11.
Am J Cardiol ; 160: 106-111, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1450050

ABSTRACT

The occurrence of venous thromboembolisms in patients with COVID-19 has been established. We sought to evaluate the clinical impact of thrombosis in patients with COVID-19 over the span of the pandemic to date. We analyzed patients with COVID-19 with a diagnosis of thrombosis who presented to the MedStar Health system (11 hospitals in Washington, District of Columbia, and Maryland) during the pandemic (March 1, 2020, to March 31, 2021). We compared the clinical course and outcomes based on the presence or absence of thrombosis and then, specifically, the presence of cardiac thrombosis. The cohort included 11,537 patients who were admitted for COVID-19. Of these patients, 1,248 had noncardiac thrombotic events and 1,009 had cardiac thrombosis (myocardial infarction) during their hospital admission. Of the noncardiac thrombotic events, 562 (45.0%) were pulmonary embolisms, 480 (38.5%) were deep venous thromboembolisms, and 347 (27.8%) were strokes. In the thrombosis arm, the mean age of the cohort was 64.5 ± 15.3 years, 53.3% were men, and the majority were African-American (64.9%). Patients with thrombosis tended to be older with more co-morbidities. The in-hospital mortality rate was significantly higher (16.0%) in patients with COVID-19 with concomitant non-cardiac thrombosis than in those without thrombosis (7.9%, p <0.001) but lower than in patients with COVID-19 with cardiac thrombosis (24.7%, p <0.001). In conclusion, patients with COVID-19 with thrombosis, especially cardiac thrombosis, are at higher risk for in-hospital mortality. However, this prognosis is not as grim as for patients with COVID-19 and cardiac thrombosis. Efforts should be focused on early recognition, evaluation, and intensifying antithrombotic management for these patients.


Subject(s)
COVID-19/physiopathology , Coronary Thrombosis/physiopathology , Hospital Mortality , Myocardial Infarction/physiopathology , Pulmonary Embolism/physiopathology , Stroke/physiopathology , Venous Thrombosis/physiopathology , Aged , Aged, 80 and over , COVID-19/complications , Coronary Thrombosis/complications , Female , Humans , Male , Middle Aged , Myocardial Infarction/complications , Pulmonary Embolism/complications , SARS-CoV-2 , Stroke/complications , Venous Thrombosis/complications
12.
Curr Rheumatol Rev ; 18(1): 83-87, 2022.
Article in English | MEDLINE | ID: covidwho-1430604

ABSTRACT

BACKGROUND: Behçet's disease (BD) is a complex vasculitis with some vascular manifestations including venous thrombosis, arterial thrombosis/aneurysm/pseudoaneurysm, and co-associated venous thrombosis and arterial lesions. We present two patients with Behçet's disease came with progressive both arterial and venous involvement. CASE PRESENTATION: The first patient was a young man with recurrent oral aphthosis and skin folliculitis and referred with complaint of new abdominal pain and 2 months severe headache. He had not referred to a physician due to COVID-19 pandemic until that time. In addition, he gradually developed a lower extremity edema and eventually was diagnosed with BD complicated with brain sagittal sinus vein thrombosis, abdominal aortic aneurysms and aortitis and deep vein thrombosis (DVT) of femoral vein. The second patient was a young woman with previous history of uveitis, DVT and recurrent oral and genital aphthosis presented with a large inguinal mass due to large iliac artery pseudoaneurysm impending to rupture, and after the operation, due to poor follow-up, developed a new femoral DVT. CONCLUSION: It seems the same inflammatory process is responsible for arterial and venous involvement in patients with BD, so it should be considered that involvement in one side (venous/arterial) can be a risk factor for the other side (venous/arterial) and early immunosuppressive treatment should always be considered to improve the prognosis.


Subject(s)
Aneurysm, False , Aneurysm , Aortitis , Behcet Syndrome , COVID-19 , Thrombosis , Venous Thrombosis , Aneurysm/complications , Aneurysm/surgery , Aneurysm, False/complications , Aortitis/complications , Behcet Syndrome/complications , Behcet Syndrome/diagnosis , COVID-19/complications , Female , Humans , Male , Pandemics , Thrombosis/complications , Venous Thrombosis/complications
13.
Hamostaseologie ; 41(5): 397-399, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1428942

ABSTRACT

Paroxysmal nocturnal haemoglobinuria (PNH) is a rare, acquired clonal haematological disease characterized by complement-mediated haemolysis, bone marrow failure and venous thrombosis. Anticomplement therapy eculizumab improves survival and reduces complications. Severe acute respiratory distress syndrome corona virus 2 (SARS-CoV-2) disease 2019 (COVID-19) is associated with high incidence of both venous and arterial thrombosis in hospitalized patients with pneumonia. Deep venous thrombosis (DVT) as the presenting symptom of COVID-19 is a rare event. We describe a well-controlled PNH patient on eculizumab for more than 5 years who presented with DVT, while on warfarin, as the first sign of COVID-19. To our knowledge, this is the first described case of DVT in a PNH patient with COVID-19.


Subject(s)
COVID-19/complications , COVID-19/diagnosis , Hemoglobinuria, Paroxysmal/complications , SARS-CoV-2 , Venous Thrombosis/complications , Adult , Antibodies, Monoclonal, Humanized/therapeutic use , Anticoagulants/therapeutic use , Complement Inactivating Agents/therapeutic use , Hemoglobinuria, Paroxysmal/drug therapy , Humans , Male , Venous Thrombosis/diagnosis , Warfarin/therapeutic use
14.
Stroke ; 52(11): e706-e709, 2021 11.
Article in English | MEDLINE | ID: covidwho-1371922
15.
Ann Vasc Surg ; 77: 79-82, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1356137

ABSTRACT

A rare case of aortic thrombosis in a young COVID-19 positive patient is presented in this case report. Arterial thrombosis developed despite the administration of anticoagulants for treating DVT and PE. The patient underwent axillobifemoral bypass surgery. Limited surgical surveillance, administered steroids and critical health status resulted in wound site infection and consequent graft removal. Aortic endarterectomy and autovenous-patch plasty were performed after the patient's condition improved. Etiopathogenesis of arterial events in the setting of COVID-19 is not entirely understood. It has been suggested that SARS-CoV-2 infection strongly affects vascular endothelial glycocalyx (VEGLX), causes systemic inflammation - reactive microvascular endotheliosis (SIRME), and consequently results in arterial thrombosis.


Subject(s)
Aorta, Thoracic , Aortic Diseases/etiology , COVID-19/complications , Pulmonary Embolism/complications , Rare Diseases , Thrombosis/etiology , Venous Thrombosis/complications , Aortic Diseases/diagnosis , Aortic Diseases/surgery , Computed Tomography Angiography , Endarterectomy/methods , Endovascular Procedures/methods , Humans , Male , Middle Aged , Pulmonary Embolism/diagnosis , Pulmonary Embolism/drug therapy , SARS-CoV-2 , Thrombosis/diagnosis , Venous Thrombosis/diagnosis , Venous Thrombosis/drug therapy
16.
J Ultrasound Med ; 41(5): 1095-1100, 2022 May.
Article in English | MEDLINE | ID: covidwho-1338189

ABSTRACT

BACKGROUND: There is growing evidence regarding the venous thromboembolic (VTE) pathophysiology of coronavirus disease 2019 (COVID-19). Several studies have reported varying incidences of this disease. OBJECTIVES: The main purpose of this study was to determine the real incidence of deep or superficial vein thrombosis in COVID-19. The study also aimed to identify risk and protective factors for VTE. METHODS: Patients were consecutively enrolled and assessed with a bilateral Duplex ultrasonography of lower limbs during hospitalization. The exam was repeated weekly until discharge, and then follow-up for 1 month. RESULTS: Two-hundred and thirty-three patients were enrolled. Mean age was 54.4 years (SD 12.7) and 47.8% were female. About 127 patients (54.5%) had comorbidities. At enrollment, patients were normotensive and had normal saturation (95.6%-SD 1.6, with a respiratory rate of 19.1 rpm-SD 4.0), with 130 needing at least supplementary oxygen therapy (55.8%). About 147 patients (63.1%) had at least 1 Duplex ultrasonography study performed and 1.7% had 5 or more studies. One patient had a distal posterior tibial vein thrombosis, which showed signs of chronicity and was congruent with the patient history. Therefore, the incidence of thrombotic events was nearly zero. DISCUSSION: Our study results suggest that performing a Duplex Ultrasonography screening protocol in stable COVID-19 patient populations, who may need hospitalization but are without symptoms of vein thrombosis, is not founded. We presumably emphasize the advantage of using intermediate LMWH doses as well as early walking in COVID-19 patients.


Subject(s)
COVID-19 , Venous Thromboembolism , Venous Thrombosis , COVID-19/complications , Female , Heparin, Low-Molecular-Weight , Humans , Male , Middle Aged , Retrospective Studies , Ultrasonography, Doppler, Duplex/methods , Venous Thrombosis/complications , Venous Thrombosis/diagnostic imaging
17.
Int J Hematol ; 114(5): 626-629, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1310613

ABSTRACT

Thrombotic thrombocytopenic purpura (TTP) is a known menace in hematology and is quite rare in practice with known triggers. Lately, in the COVID-19 pandemic, hematology has seen a new pathology amongst which TTP associated with COVID-19 messenger RNA (mRNA) vaccine is unique. We report a case of a 69-year-old male with multiple comorbidities who presented to the hospital with severe fatigue and shortness of breath. Labs were significant for thrombocytopenia, anemia, and hemolysis with schistocytes consistent with TTP with a second dose of BNT162b2 mRNA vaccine as a likely culprit been documented.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19 , Immunization, Secondary/adverse effects , Pandemics , Purpura, Thrombotic Thrombocytopenic/etiology , SARS-CoV-2 , ADAMTS13 Protein/immunology , Aged , COVID-19/prevention & control , COVID-19 Vaccines/immunology , Combined Modality Therapy , Dyspnea/etiology , Fatigue/etiology , HIV Infections/complications , Hepatitis B, Chronic/complications , Humans , Hypertension/complications , Immunosuppressive Agents/therapeutic use , Kidney Failure, Chronic/complications , Male , Plasma Exchange , Purpura, Thrombotic Thrombocytopenic/blood , Purpura, Thrombotic Thrombocytopenic/therapy , Venous Thrombosis/complications
19.
Viruses ; 13(5)2021 05 11.
Article in English | MEDLINE | ID: covidwho-1224259

ABSTRACT

Infection with SARS-CoV-2 leading to COVID-19 induces hyperinflammatory and hypercoagulable states, resulting in arterial and venous thromboembolic events. Deep vein thrombosis (DVT) has been well reported in COVID-19 patients. While most DVTs occur in a lower extremity, involvement of the upper extremity is uncommon. In this report, we describe the first reported patient with an upper extremity DVT recurrence secondary to COVID-19 infection.


Subject(s)
COVID-19/complications , COVID-19/diagnosis , Venous Thrombosis/complications , Venous Thrombosis/diagnosis , Aged, 80 and over , Blood Coagulation Disorders/complications , Humans , Male , Neoplasm Recurrence, Local , Polymerase Chain Reaction , RNA, Viral , Recurrence , Risk Factors , Upper Extremity/blood supply , Venous Thrombosis/therapy
20.
Stroke ; 52(5): e117-e130, 2021 05.
Article in English | MEDLINE | ID: covidwho-1195876
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