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Published on: December 19, 2020
Pulmonary Embolism in Hospitalized Patient with Coronavirus Disease 2019 (COVID-19)
Wulyo Rajabto1, Dimas Priantono, Rahmad Mulyadi
1Division of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. wulyo02@gmail.com.
Insights
COVID-19 patients face high risks of dangerous blood clots like pulmonary embolism. Early anticoagulant treatment, including low molecular weight heparin and DOACs, is crucial for managing COVID-19 coagulopathy and improving outcomes.
Area of Science:
- Medical Science
- Infectious Diseases
- Cardiology
Background:
- Coronavirus disease 2019 (COVID-19) is a global pandemic associated with a high incidence of thrombosis.
- Thromboembolic complications, particularly pulmonary embolism, significantly increase mortality in hospitalized COVID-19 patients.
- COVID-19 induces a hypercoagulable state, activating the coagulation cascade.
Purpose of the Study:
- To review the risks and management of thromboembolic complications in COVID-19.
- To highlight the diagnostic role of CT pulmonary angiography in COVID-19 patients.
- To discuss anticoagulant treatment strategies for COVID-19-associated coagulopathy.
Main Methods:
- Review of current literature on COVID-19, thrombosis, and anticoagulation.
- Analysis of diagnostic imaging modalities, including CT pulmonary angiography.
- Evaluation of anticoagulant therapies, focusing on low molecular weight heparin and direct oral anticoagulants (DOACs).
Main Results:
- Thrombosis affects up to one-third of hospitalized COVID-19 patients.
- Pulmonary embolism is a frequent and dangerous complication, increasing mortality.
- Low molecular weight heparin is recommended for its safety and efficacy.
- Pulmonary embolism can occur independently of deep vein thrombosis.
Conclusions:
- Hospitalized COVID-19 patients are at high risk for thromboembolic events.
- Prompt diagnosis using CT pulmonary angiography is essential.
- Parenteral anticoagulation followed by DOACs is the recommended treatment for COVID-19 coagulopathy.
Abstract:
Coronavirus disease 2019 (COVID-19) has been a global pandemic for over a year. Meanwhile, thrombosis occurs in up to one-third of hospitalized patients with the disease, while pulmonary embolism has been reported to be the most dangerous thrombosis which greatly increases mortality in COVID-19.Hospitalized patients with COVID-19 are at high risk of thromboembolic complications such as deep vein thrombosis and pulmonary embolism. The hypercoagulable state caused by COVID-19 leads to activation of coagulation cascade, meanwhile, CT pulmonary angiography is used to diagnose or exclude pulmonary embolism. Furthermore, ground-glass opacities are also evaluated using this modality. Low molecular weight heparin is the anticoagulant of choice due to simplicity in administration and low risk of drug-drug interactions.Pulmonary embolism occurs in COVID-19 patients without DVT. Based on the results, parenteral anticoagulant followed by DOAC is the mainstay of treatment in COVID-19 coagulopathy.
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