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Persistent Hypercoagulable State in COVID-19: A Case Series of COVID-19 Associated Pulmonary Embolism

Kok Hoe Chan1, Su Lin Lim1, Hamid Shaaban1,2

  • 1Department of Internal Medicine, Saint Michael's Medical Centre, New York Medical College, Newark, New Jersey, USA.

Journal of Global Infectious Diseases
|April 29, 2021
PubMed

Insights

COVID-19 patients may experience blood clot risks, including pulmonary embolism, even during recovery. Continued monitoring and blood clot prevention are recommended post-discharge.

Area of Science:

  • Infectious Diseases
  • Hematology
  • Pulmonology

Background:

  • Coronavirus disease 2019 (COVID-19) has caused significant global morbidity and mortality.
  • COVID-19-associated coagulopathy is a major contributor to adverse outcomes.
  • Coagulopathy is often observed in moderate-to-severe COVID-19 cases, particularly during the recovery phase.

Purpose of the Study:

  • To report a case series of pulmonary embolism in patients with COVID-19 during the late phase of illness.
  • To investigate the persistence of hypercoagulability risk into the recovery phase of COVID-19.
  • To hypothesize the need for extended monitoring and thromboprophylaxis in recovering COVID-19 patients.

Main Methods:

  • Case series analysis of two patients with COVID-19.
  • Clinical observation of disease progression and complication development.
  • Review of laboratory markers indicative of coagulopathy (D-dimer, fibrinogen).

Main Results:

  • Two patients with COVID-19 developed pulmonary embolism in the late phase of their illness.
  • Findings suggest that hypercoagulability may persist into the recovery phase.
  • Pulmonary embolism occurred despite observations typically limited to the recovery/postcytokine storm state.

Conclusions:

  • The risk of hypercoagulability in COVID-19 patients may extend into the recovery phase.
  • Continuous monitoring of D-dimer and fibrinogen levels is warranted during recovery.
  • Post-discharge thromboprophylaxis for at least two weeks is recommended for COVID-19 patients.

Keywords:
Anticoagulationcoronavirus disease 2019hypercoagulablepulmonary embolismsevere acute respiratory syndrome coronavirus 2

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