1. A unique tale of COVID-19 induced concomitant overt disseminated intravascular coagulation and acute bilateral pulmonary embolism.
- Author
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Siddiqui, Saquib Navid, Jayasekhar, Roland, Tshering, Sonam, Jugjali, Ranjana, Shanmugavadivel, Devipangaj, Jawed, Asheer, and Rahman, Mohammed Mostafizur
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COVID-19 , *PULMONARY embolism , *DISSEMINATED intravascular coagulation , *SARS-CoV-2 , *VENA cava inferior , *BLOOD products , *DIAGNOSIS - Abstract
• Full therapeutic low molecular weight heparin to be considered if platelets >50,000. • Blood products for overt disseminated intravascular coagulation with active bleeding. • Anti-coagulation dose should be half of the therapeutic dose if platelets <50,000. • Only prophylactic dose if platelets <30,000. • Platelet transfusion and an inferior vena cava filter considered if platelets <30,000. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2), a novel coronavirus, originated as an epidemic respiratory illness in Wuhan, China. COVID-19 eventually spread to almost all countries and has now been declared a global pandemic disease by the World Health Organisation. A plethora of research has explored the dynamics of different clinical entities related to SARS-COV-2, in particular, COVID-19 associated coagulopathy. A large scale of patients have been reported to have developed pulmonary embolism without any other standard triggers or risk factors, leading to speculation that COVID-19 is an independent risk factor for venous thromboembolism. In addition to the development of thromboembolic complications such as pulmonary embolism, COVID-19 has also been reported to have triggered disseminated intravascular coagulation (DIC); however, it is unclear whether pulmonary embolism was due to COVID-19-induced thrombosis or a result of coagulopathy secondary to DIC. We describe a unique case of a COVID-19 associated coagulopathy in a patient with confirmed pulmonary embolism along with an overt DIC. Following diagnosis, the challenge was to identify the appropriate treatment modality for this unique situation. The patient was treated with anticoagulants and steroids along with blood products. The patient's condition markedly improved and was clinically stable on discharge. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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