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Acute cor pulmonale from saddle pulmonary embolism in a patient with previous COVID-19: should we prolong
Sadaf Ali1, Smitha Mathew2, Joseph M Pappachan1
1Department of Medicine and Endocrinology, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust, Preston, PR2 9HT, United Kingdom.
Insights
Even mild coronavirus disease 2019 (COVID-19) may increase risks for blood clots. A case report suggests extended anticoagulation might be needed post-hospitalization for COVID-19 patients, even those without high-risk factors.
Area of Science:
- Medicine
- Cardiology
- Pulmonology
Background:
- Severe coronavirus disease 2019 (COVID-19) is linked to increased thromboembolism risk.
- The thromboembolic risk in mild to moderate COVID-19 is not well-established.
- Current guidelines lack recommendations for thromboembolism prophylaxis post-hospitalization for low-risk COVID-19 patients.
Abstract:
Severe coronavirus disease 2019 (COVID-19) is known to be associated with a heightened risk of thromboembolism. However, the risk associated with mild and moderate illness from COVID-19 is unknown, and there is no current recommendation for prophylaxis against thromboembolism in patients after hospital treatment, unless there are established thrombophilic risk factors. We report the case of a 52-year-old woman who presented with massive saddle pulmonary embolism 1 week after initial hospital discharge, which was treated successfully with thrombolysis. This case raises the question of whether extended prophylactic anticoagulation should be considered even in low-risk COVID-19 cases.
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