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Can't Dissolve Me Now: A COVID-19 Provoked Venous Thromboembolism Breaks Through Apixaban: Case Report

Alexander W Arena1, Ahmad Hussein1, Ellen J Kurkowski1

  • 1St. John's Riverside Hospital, Department of Emergency Medicine, Yonkers, New York.

Clinical Practice and Cases in Emergency Medicine
|August 26, 2021
PubMed

Insights

This case study highlights a severe venous thromboembolism (VTE) event in a COVID-19 patient, even with anticoagulant treatment. Further research is needed for optimal VTE prevention and management in these patients.

Area of Science:

  • Cardiology
  • Pulmonology
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) is increasingly recognized as a condition affecting multiple organ systems.
  • Evidence suggests COVID-19 can cause endotheliopathy, leading to hypercoagulable states.
  • Hypercoagulability is a significant risk factor for venous thromboembolism (VTE).

Purpose of the Study:

  • To report a case of deep venous thrombosis and pulmonary embolism in a COVID-19 patient.
  • To illustrate the potential for worsening VTE despite standard anticoagulant therapy.
  • To emphasize the need for optimized VTE management protocols in COVID-19.

Main Methods:

  • Case report from an emergency department setting.
  • Detailed clinical presentation of a patient with COVID-19.
  • Monitoring of VTE progression during apixaban treatment.

Main Results:

  • A patient with COVID-19 developed deep venous thrombosis and pulmonary embolism.
  • The VTE extended despite adherence to apixaban therapy.
  • This indicates a potential challenge in managing VTE in COVID-19 patients.

Conclusions:

  • This case underscores the complex relationship between COVID-19 and VTE.
  • Further investigation into optimal anticoagulation dosages and treatment strategies for COVID-19 patients is crucial.
  • Developing effective protocols is essential to prevent and manage VTE progression in this population.
Abstract

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