Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 66
Filter
Add filters

Document Type
Year range
1.
BMC Infect Dis ; 21(1): 1275, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1582104

ABSTRACT

BACKGROUND: To investigate the association of primary acute cerebral venous thrombosis (CVT) with COVID-19 vaccination through complete ascertainment of all diagnosed CVT in the population of Scotland. METHODS: Case-crossover study comparing cases of CVT recently exposed to vaccination (1-14 days after vaccination) with cases less recently exposed. Cases in Scotland from 1 December 2020 were ascertained through neuroimaging studies up to 17 May 2021 and diagnostic coding of hospital discharges up to 28 April 2021, linked to national vaccination records. The main outcome measure was primary acute CVT. RESULTS: Of 50 primary acute CVT cases, 29 were ascertained only from neuroimaging studies, 2 were ascertained only from hospital discharges, and 19 were ascertained from both sources. Of these 50 cases, 14 had received the Astra-Zeneca ChAdOx1 vaccine and 3 the Pfizer BNT162b2 vaccine. The incidence of CVT per million doses in the first 14 days after vaccination was 2.2 (95% credible interval 0.9 to 4.1) for ChAdOx1 and 1 (95% credible interval 0.1 to 2.9) for BNT162b2. The rate ratio for CVT associated with exposure to ChAdOx1 in the first 14 days compared with exposure 15-84 days after vaccination was 3.2 (95% credible interval 1.1 to 9.5). CONCLUSIONS: These findings support a causal association between CVT and the AstraZeneca vaccine. The absolute risk of post-vaccination CVT in this population-wide study in Scotland was lower than has been reported for populations in Scandinavia and Germany; the explanation for this is not clear.


Subject(s)
COVID-19 , Venous Thrombosis , COVID-19 Vaccines , Cross-Over Studies , Humans , Neuroimaging , SARS-CoV-2 , Scotland/epidemiology , Vaccination , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/epidemiology
3.
BMJ Case Rep ; 14(11)2021 Nov 16.
Article in English | MEDLINE | ID: covidwho-1522934

ABSTRACT

Renal arteriovenous malformation is a primarily congenital renal vascular abnormality. It is usually diagnosed incidentally on imaging, and the most common subtype is 'cirsoid', consisting of multiple, enlarged arterial feeders interconnecting with draining veins. We present a 74-year-old woman with an incidental finding of what was at first considered a hypervascularised kidney tumour but turned out to be a left intrarenal arteriovenous malformation associated with a left renal vein thrombosis. Selective endovascular embolisation was performed. The cause-consequence relationship between the arteriovenous malformation and the thrombosis is unique. To our knowledge, no such case has ever been reported.


Subject(s)
Arteriovenous Malformations , Kidney Neoplasms , Urologic Diseases , Venous Thrombosis , Aged , Arteriovenous Malformations/complications , Arteriovenous Malformations/diagnostic imaging , Female , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/diagnostic imaging , Renal Veins/diagnostic imaging , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/etiology
4.
J Minim Invasive Gynecol ; 28(11): 1951-1952, 2021 11.
Article in English | MEDLINE | ID: covidwho-1397500

ABSTRACT

An abundance of literature has demonstrated that coronavirus disease (COVID-19) contributes to a hypercoagulable state that is associated with venous thromboembolic events. Data on postoperative complications after a mild COVID-19 infection are limited. We report a case of ovarian vein thrombosis after pelvic surgery in a patient with a recent mild COVID-19 infection. The patient presented with complaints of fever and worsening right-sided abdominal pain postoperatively and was found to have a right ovarian vein thrombosis. Thrombophilia workup was negative. The hypercoagulable state of patients with COVID-19 may have implications on postoperative complications after gynecologic surgery even in cases of mild infection. Further research is needed to determine the optimal thromboembolic prophylaxis for patients undergoing pelvic surgery after a COVID-19 infection.


Subject(s)
COVID-19 , Thrombosis , Venous Thrombosis , Female , Gynecologic Surgical Procedures/adverse effects , Humans , SARS-CoV-2 , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/etiology
6.
Nat Commun ; 12(1): 4663, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1338537

ABSTRACT

Vaccine-induced thrombotic thrombocytopenia with cerebral venous thrombosis is a syndrome recently described in young adults within two weeks from the first dose of the ChAdOx1 nCoV-19 vaccine. Here we report two cases of malignant middle cerebral artery (MCA) infarct and thrombocytopenia 9-10 days following ChAdOx1 nCoV-19 vaccination. The two cases arrived in our facility around the same time but from different geographical areas, potentially excluding epidemiological links; meanwhile, no abnormality was found in the respective vaccine batches. Patient 1 was a 57-year-old woman who underwent decompressive craniectomy despite two prior, successful mechanical thrombectomies. Patient 2 was a 55-year-old woman who developed a fatal bilateral malignant MCA infarct. Both patients manifested pulmonary and portal vein thrombosis and high level of antibodies to platelet factor 4-polyanion complexes. None of the patients had ever received heparin in the past before stroke onset. Our observations of rare arterial thrombosis may contribute to assessment of possible adverse effects associated with COVID-19 vaccination.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/immunology , Cerebral Infarction/chemically induced , Purpura, Thrombocytopenic, Idiopathic/chemically induced , SARS-CoV-2/immunology , Thrombosis/chemically induced , Autoantibodies/blood , Autoantibodies/immunology , COVID-19/virology , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/immunology , Cerebral Infarction/diagnostic imaging , Computed Tomography Angiography/methods , Female , Humans , Magnetic Resonance Imaging/methods , Middle Aged , Platelet Factor 4/immunology , Purpura, Thrombocytopenic, Idiopathic/diagnostic imaging , SARS-CoV-2/physiology , Thrombosis/diagnostic imaging , Tomography, X-Ray Computed/methods , Vaccination/adverse effects , Venous Thrombosis/chemically induced , Venous Thrombosis/diagnostic imaging
8.
BMJ Case Rep ; 14(6)2021 Jun 15.
Article in English | MEDLINE | ID: covidwho-1270883

ABSTRACT

Isolated cortical vein thrombosis (ICVT) is a rare entity and accounts for only 6.3% of cerebral venous and sinus thrombosis. ICVT is an uncommon cause of seizures in young adults. We present a 27-year-old man with no medical history who presented with dizziness, loss of consciousness and a seizure-like episode. The patient was found to have an elevated D-dimer and brain imaging revealed ICVT. The patient was started on anticoagulation and antiseizure medications. A high index of suspicion for uncommon aetiologies for new-onset seizure, especially in the young, is key to accurate diagnosis of ICVT. Evaluation and work-up should include detailed physical examination, along with appropriate brain imaging and testing for other conditions that predispose venous thrombosis. In the setting of the SARS-CoV-2 pandemic, testing for COVID-19 may also be warranted. Rapid diagnosis and full anticoagulation can help avoid debilitating complications and long-term sequelae.


Subject(s)
COVID-19 , Cerebral Veins , Intracranial Thrombosis , Venous Thrombosis , Adult , COVID-19 Testing , Cerebral Veins/diagnostic imaging , Humans , Intracranial Thrombosis/diagnostic imaging , Intracranial Thrombosis/drug therapy , Male , SARS-CoV-2 , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/drug therapy , Young Adult
10.
PLoS One ; 16(5): e0251966, 2021.
Article in English | MEDLINE | ID: covidwho-1236594

ABSTRACT

OBJECTIVE: The aim of this study was to assess the incidence of deep vein thrombosis (DVT) of the lower limbs, using serial compression ultrasound (CUS) surveillance, in acutely ill patients with COVID-19 pneumonia admitted to a non-ICU setting. METHODS: Multicenter, prospective study of patients with COVID-19 pneumonia admitted to Internal Medicine units. All patients were screened for DVT of the lower limbs with serial CUS. Anticoagulation was defined as: low dose (enoxaparin 20-40 mg/day or fondaparinux 1.5-2.5 mg/day); intermediate dose (enoxaparin 60-80 mg/day); high dose (enoxaparin 120-160 mg or fondaparinux 5-10 mg/day or oral anticoagulation). The primary end-point of the study was the diagnosis of DVT by CUS. RESULTS: Over a two-month period, 227 consecutive patients with moderate-severe COVID-19 pneumonia were enrolled. The incidence of DVT was 13.7% (6.2% proximal, 7.5% distal), mostly asymptomatic. All patients received anticoagulation (enoxaparin 95.6%) at the following doses: low 57.3%, intermediate 22.9%, high 19.8%. Patients with and without DVT had similar characteristics, and no difference in anticoagulant regimen was observed. DVT patients were older (mean 77±9.6 vs 71±13.1 years; p = 0.042) and had higher peak D-dimer levels (5403 vs 1723 ng/mL; p = 0.004). At ROC analysis peak D-dimer level >2000 ng/mL (AUC 0.703; 95% CI 0.572-0.834; p = 0.004) was the most accurate cut-off value able to predict DVT (RR 3.74; 95%CI 1.27-10, p = 0.016). CONCLUSIONS: The incidence of DVT in acutely ill patients with COVID-19 pneumonia is relevant. A surveillance protocol by serial CUS of the lower limbs is useful to timely identify DVT that would go otherwise largely undetected.


Subject(s)
COVID-19/diagnostic imaging , Venous Thrombosis/epidemiology , Aged , Aged, 80 and over , Anticoagulants/therapeutic use , COVID-19/complications , Enoxaparin/therapeutic use , Female , Fondaparinux/therapeutic use , Humans , Incidence , Lower Extremity/blood supply , Male , Middle Aged , Ultrasonography , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/drug therapy , Venous Thrombosis/etiology
11.
J Med Vasc ; 46(4): 163-170, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1230604

ABSTRACT

INTRODUCTION: The COVID-19 pandemic is associated with a high incidence of venous thromboembolism questioning the utility of a systematic screening for deep venous thrombosis (DVT) in hospitalised patients. METHODS: In this prospective bicentric controlled study, 4-point ultrasound using a pocket device was used to screen for DVT, in patients with SARS-CoV-2 infection and controls admitted for acute medical illness not related to COVID-19 hospitalised in general ward, in order to assess the utility of a routine screening and to estimate the prevalence of VTE among those patients. RESULTS: Between April and May 2020, 135 patients were screened, 69 in the COVID+ group and 66 in the control one. There was no significant difference in the rate of proximal DVT between the two groups (2.2% vs. 1.5%; P=0.52), despite the high rate of PE diagnosed among COVID-19 infected patients (10.1% vs. 1.5%, P=0.063). No isolated DVT was detected, 37.5% of PE was associated with DVT. Mortality (7.2% vs. 1.5%) was not different (P=0.21) between COVID-19 patients and controls. CONCLUSION: The systematic screening for proximal DVT was not found to be relevant among COVID-19 patients hospitalized in general ward despite the increase of VTE among this population. Further studies are needed to confirm the hypothesis of a local pulmonary thrombosis which may lead to new therapeutic targets.


Subject(s)
COVID-19/epidemiology , Diagnostic Screening Programs , Hospitalization , Pulmonary Embolism/diagnostic imaging , Ultrasonography , Venous Thrombosis/diagnostic imaging , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/mortality , Case-Control Studies , Female , France/epidemiology , Humans , Incidence , Male , Middle Aged , Predictive Value of Tests , Prevalence , Prospective Studies , Pulmonary Embolism/epidemiology , Risk Assessment , Risk Factors , Unnecessary Procedures , Venous Thrombosis/epidemiology
12.
J Cosmet Dermatol ; 20(10): 3116-3118, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1225675

ABSTRACT

While myriad skin manifestations have been reported with COVID, they are insignificant as compared to the number of cases and do not indicate specificity as the studies that report them have either been based on telephonic consultation or have not been compared with case-control analysis from a normal skin OPD or IPD referral population. The most feared complication of COVID-19 is the combination of coagulopathy and thromboembolism, which is consequent to thrombo-inflammation and a heightened prothrombotic state. It is exaggerated in severe COVID associated with sepsis and skin manifestations that correlate with severity are more useful to clinicians. We had a case of COVID-positive 65-year-old man with features of thromboembolism followed by general symptoms of cough and fever. D-dimer test was positive, and the Ultrasound Doppler showed thrombosis in the right lower limb arteries and deep vein thrombosis in right lower limb veins.


Subject(s)
COVID-19 , Pulmonary Embolism , Sepsis , Venous Thrombosis , Aged , Aorta , Gangrene , Humans , Male , Pulmonary Embolism/complications , Pulmonary Embolism/diagnostic imaging , SARS-CoV-2 , Sepsis/complications , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/etiology
13.
Med Clin (Barc) ; 157(4): 172-175, 2021 08 27.
Article in English, Spanish | MEDLINE | ID: covidwho-1152572

ABSTRACT

BACKGROUND: Deep vein thrombosis (DVT) and pulmonary embolism (PE) are both complications linked with COVID-19. Lower limb point-of-care clinical ultrasound (POCUS) could detect occult clots, helping decide whom to treat with anticoagulation. OBJECTIVES: To determine proximal DVT prevalence with POCUS screening among hospitalized COVID-19 patients. PATIENTS/METHODS: Lower limb POCUS was performed in all patients admitted either to the ward or intensive care unit (ICU) between April 22nd and 30th 2020. Clinical and laboratory features, prescriptions, thrombotic complications and outcomes were assessed. RESULTS: 87 patients were screened, of which 26 (29.8%) either had been discharged from ICU (19.5%) or were still in critical condition (10.3%). DVT was found in 4 patients (3 femoral, 1 popliteal), of which 1 had not received low molecular weight heparin (LMWH) prophylaxis. 21 CT pulmonary angiograms were performed, being positive for PE in 5 cases (23.8%); only 2 of these patients suffered DVT. CONCLUSIONS: Screening lower extremities with POCUS did not find a high rate of DVT among patients receiving LMWH-prophylaxis. However, there was a noteworthy amount of PE without DVT.


Subject(s)
COVID-19 , Pulmonary Embolism , Venous Thrombosis , Anticoagulants/therapeutic use , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Point-of-Care Systems , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/epidemiology , Pulmonary Embolism/etiology , SARS-CoV-2 , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/epidemiology , Venous Thrombosis/prevention & control
14.
BMJ Case Rep ; 14(3)2021 Mar 16.
Article in English | MEDLINE | ID: covidwho-1138311

ABSTRACT

We present a case of a giant ovarian cyst in a 20-year-old woman who presented atypically at our Emergency Department with left-sided back pain followed by acute left leg swelling. Blood tests showed significantly raised C-Reactive Protein and D-Dimer. CT-Abdomen-Pelvis demonstrated a large mass in the region of the right ovary with suspicious heterogeneous filling defects in the left external iliac vein, confirmed as a left-sided deep-vein thrombosis on ultrasound Doppler. MRI revealed the lesion to be cystic and the deep venous thrombosis was treated with twice-daily Clexane. Prior to removal of the cyst, an Inferior Vena Cava Filter was placed to reduce thromboembolic risk. The cyst was resected without complication and the postoperative period was uneventful. This case occurred while face-to-face services were limited by COVID-19 and illustrates the need for robust systemic measures to safeguard patients against the emergency sequelae of insidious gynaecological pathology.


Subject(s)
Back Pain/etiology , Diagnostic Imaging/methods , Ovarian Cysts/complications , Ovarian Cysts/diagnostic imaging , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/etiology , Adult , Diagnosis, Differential , Enoxaparin/therapeutic use , Female , Fibrinolytic Agents/therapeutic use , Humans , Leg , Magnetic Resonance Imaging , Ovarian Cysts/surgery , Ovary/diagnostic imaging , Ovary/surgery , Tomography, X-Ray Computed , Ultrasonography, Doppler , Venous Thrombosis/drug therapy , Young Adult
15.
Tidsskr Nor Laegeforen ; 140(18)2020 12 15.
Article in Norwegian | MEDLINE | ID: covidwho-1117720

ABSTRACT

BACKGROUND: There is emerging evidence of an increased risk of venous thromboembolism as well as several reports of cerebral venous thrombosis in COVID-19. CASE PRESENTATION: A previously healthy man in his fifties was admitted due to sudden confusion and reduced consciousness. One month earlier the patient had symptoms with headache, fever, dry cough, vomiting and diarrhoea and reduced sense of taste and smell. He was diagnosed with COVID-19 and the symptoms were mainly resolved within three weeks. On admission the patient was disorientated with aphasia. Brain imaging revealed a haemorrhagic infarction in the left temporal lobe due to thrombosis of the left transverse sinus and low-molecular weight heparin was instituted. On follow-up four months later, there was clinical improvement with only slight problems with short term memory and concentration. INTERPRETATION: This case illustrates the risk of serious neurological complications due to cerebral venous thrombosis in COVID-19.


Subject(s)
COVID-19/complications , Intracranial Thrombosis/virology , Venous Thrombosis/virology , Brain/diagnostic imaging , Humans , Intracranial Thrombosis/diagnostic imaging , Intracranial Thrombosis/drug therapy , Male , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/drug therapy
16.
Eur Rev Med Pharmacol Sci ; 25(4): 2123-2130, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1116633

ABSTRACT

OBJECTIVE: Diffuse thrombosis represents one of the most predominant causes of death by COVID-19 and SARS-CoV-2 infection seems to increase the risk of developing venous thromboembolic diseases (VTE). Aim of this study is to analyze the relationship between validated predictive scores for VTE such as IMPROVE and IMPROVEDD and: (1) Intensification of Care (IoC, admission to Pulmonology Department or Intensive Care Unit) (2) in-hospital mortality rate 3) 30-days mortality rate. PATIENTS AND METHODS: We retrospectively evaluated 51 adult patients with laboratory diagnosis of SARS-CoV-2 infection and calculated IMPROVE and IMPROVEDD scores. All patients underwent venous color-Doppler ultrasound of the lower limbs to assess the presence of superficial vein thrombosis (SVT) and/or deep vein thrombosis (DVT). Patients with normal values of D-dimer did not receive heparin therapy (LMWH); patients with ≥ 4 ULN values of D-dimer or with a diagnosis of DVT were treated with therapeutic LMWH dosage, while the remaining patients were treated with prophylactic LMWH dosages. RESULTS: We found strong relations between IMPROVE score and the need for IoC and with the in-hospital mortality rate and between the IMPROVEDD score and the need for IoC. We defined that an IMPROVE score greater than 4 points was significantly associated to in-hospital mortality rate (p = 0.05), while an IMPROVEDD score greater than 3 points was associated with the need for IoC (p = 0.04). Multivariate logistic analysis showed how IMPROVE score was significantly associated to in-hospital and 30-days mortality rates. CONCLUSIONS: IMPROVE score can be considered an independent predictor of in-hospital and 30-days mortality.


Subject(s)
COVID-19/complications , Fibrinolytic Agents/therapeutic use , Heparin, Low-Molecular-Weight/therapeutic use , SARS-CoV-2 , Venous Thrombosis/prevention & control , Adult , COVID-19/blood , COVID-19/diagnostic imaging , COVID-19/mortality , Critical Care/statistics & numerical data , Disease-Free Survival , Fibrin Fibrinogen Degradation Products/analysis , Fibrinolytic Agents/administration & dosage , Heparin, Low-Molecular-Weight/administration & dosage , Humans , Italy , Logistic Models , Lower Extremity/diagnostic imaging , Multivariate Analysis , Retrospective Studies , Risk Assessment , Risk Factors , Ultrasonography, Doppler, Duplex , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/etiology , Venous Thrombosis/mortality
20.
Clin Imaging ; 75: 1-4, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1039316

ABSTRACT

We describe a 40-year-old man with severe COVID-19 requiring mechanical ventilation who developed aorto-bi-iliac arterial, right lower extremity arterial, intracardiac, pulmonary arterial and ilio-caval venous thromboses and required right lower extremity amputation for acute limb ischemia. This unique case illustrates COVID-19-associated thrombotic complications occurring at multiple, different sites in the cardiovascular system of a single infected patient.


Subject(s)
COVID-19 , Hypertension, Pulmonary , Thrombosis , Venous Thrombosis , Adult , Amputation , Humans , Leg/diagnostic imaging , Leg/surgery , Lower Extremity/diagnostic imaging , Lower Extremity/surgery , Male , SARS-CoV-2 , Thrombosis/diagnostic imaging , Thrombosis/etiology , Thrombosis/surgery , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/surgery
SELECTION OF CITATIONS
SEARCH DETAIL
...