Thrombolysis and use of argatroban for the treatment of massive pulmonary embolism following anticoagulation failure in a patient with COVID-19.
Am J Health Syst Pharm
; 77(23): 1961-1964, 2020 11 16.
Article
in English
| MEDLINE | ID: covidwho-706948
ABSTRACT
PURPOSE:
Successful use of alteplase and argatroban to treat a patient with coronavirus disease 2019 (COVID-19)-associated massive pulmonary embolism with cardiac arrest is reported.SUMMARY:
This case report describes a 42-year-old male with COVID-19 who developed a massive pulmonary embolism resulting in cardiac arrest after suspected failure of low-molecular-weight heparin therapy for a deep venous thrombosis. Administration of two 50-mg doses of intravenous alteplase resulted in return of spontaneous circulation, and low-dose argatroban was used as follow-up anticoagulation therapy without complications. This is the first case report of use of argatroban in a patient with COVID-19 with cardiac arrest-associated massive pulmonary embolism after failure of previous anticoagulation efforts.CONCLUSION:
Argatroban may be used as an alternate anticoagulation strategy in COVID-19 patients who fail low-molecular weight therapy. A risk versus benefit discussion should be had regarding appropriateness of therapy as well as dosing. More data is needed to understand the unique hypercoagulable condition in COVID-19 patients as well as research that further highlights the role of argatroban and bivalirudin therapy in this patient population.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pipecolic Acids
/
Pneumonia, Viral
/
Pulmonary Embolism
/
Thrombolytic Therapy
/
Coronavirus Infections
/
Fibrinolytic Agents
/
Anticoagulants
Type of study:
Case report
/
Cohort study
/
Prognostic study
Topics:
Long Covid
/
Vaccines
Limits:
Adult
/
Humans
/
Male
Language:
English
Journal:
Am J Health Syst Pharm
Journal subject:
Pharmacy
/
Hospitals
Year:
2020
Document Type:
Article
Affiliation country:
Ajhp
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