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Phlegmasia cerulea dolens superimposed on disseminated intravascular coagulation in COVID-19

Daniele Orso1, Lisa Mattuzzi2, Sara Scapol3

  • 1University of Udine. sd7782.do@gmail.com.

Acta Bio-Medica : Atenei Parmensis
|September 6, 2021
PubMed

Insights

Severe COVID-19 can cause rare, life-threatening phlegmasia cerulea dolens (PCD) even with anticoagulation. This case highlights COVID-19

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Hematology

Background:

  • COVID-19 is linked to cardiovascular complications, including coagulopathy.
  • Elevated fibrinogen and D-dimer levels are common in COVID-19 patients, increasing adverse event risk.
  • Phlegmasia cerulea dolens (PCD) is a rare, severe form of deep vein thrombosis.

Observation:

  • A 64-year-old patient with severe COVID-19 pneumonia developed PCD.
  • The patient exhibited persistently elevated activated partial thromboplastin time and international normalized ratio.
  • This occurred despite ongoing anticoagulation therapy.

Findings:

  • This case presents a rare instance of COVID-19 associated with PCD.
  • It occurred despite the patient having indicators of anticoagulation (elevated aPTT and INR).
  • This challenges the typical understanding of thrombosis risk in COVID-19.

Implications:

  • Highlights the complex coagulopathy associated with COVID-19.
  • Suggests that severe COVID-19 may predispose to rare thrombotic events like PCD.
  • Underscores the need for vigilance in managing thrombosis in COVID-19 patients, even with anticoagulation.

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