MORE ON DEEP HEMATOMAS IN PATIENTS WITH COVID-19: CASE SERIES

Area of Science:

• Medicine
• Hematology
• Infectious Diseases

Background:

• COVID-19 infection can disrupt the hemocoagulation system.
• The exact nature of this imbalance, whether thrombosis or hemorrhage prevails, remains unclear.
• Deep hematomas have been increasingly reported in COVID-19 patients, necessitating further investigation.

Purpose of the Study:

• To investigate the characteristics and outcomes of hematoma formation in hospitalized COVID-19 patients.
• To analyze the coagulation status and mortality associated with hematoma development during COVID-19 infection.

Main Methods:

• Observation of 7 COVID-19 patients who developed hematomas between October 2020 and January 2021.
• Assessment of patient severity using SOFA and Caprini scales, and treatment with therapeutic doses of calcium nadroparin.
• Diagnostic imaging (ultrasound, CT) and analysis of coagulograms, including D-dimer levels.

Main Results:

• Seven patients (2.1% of hospitalized) developed hematomas, with 5 cases of deep hematomas up to 340 ml.
• Median time to hematoma onset was 7 days; 3 patients with D-dimer >4000 ng/ml had fatal outcomes with pulmonary artery thrombosis.
• Mortality rate in patients with hematomas was 42.9%, significantly higher than the hospital average of 7.1%.

Conclusions:

• COVID-19 is characterized by a coagulation imbalance involving both thrombotic and hemorrhagic complications.
• Deep hematomas are a poorly understood manifestation of severe COVID-19 that significantly worsens patient prognosis.
• The findings underscore the complex hemostatic challenges posed by COVID-19 infection.