An evaluation of venous thromboembolism by whole-body enhanced CT scan for critical COVID-19 pneumonia with markedly rises of coagulopathy related factors: a case series study

Thrombosis Journal

Yasufumi Oi¹  Kento Nakajima¹  Takeru Abe¹  Reo Matsumura¹  Fumihiro Ogawa¹  Tomoki Nakagawa¹  Takao Miyagawa¹  Ichiro Takeuchi¹ 

[1] Department of Emergency Medicine, Yokohama City University, School of Medicine, 3-9 Fukuura, Kanazawa-ku, 236-0004, Yokohama, Kanagawa, Japan;

关键词: COVID-19;    Venous thromboembolism;    Whole-body CT scan;    D-dimer;    Coagulopathy;    Anticoagulant;   

DOI  :  10.1186/s12959-021-00280-z

来源: Springer

【 摘 要 】

BackgroundCoronavirus disease (COVID-19) pneumonitis associated with severe respiratory failure has a high mortality rate. Based on recent reports, the most severely ill patients present with coagulopathy, and disseminated intravascular coagulation (DIC)-like massive intravascular clot formation is frequently observed. Coagulopathy has emerged as a significant contributor to thrombotic complications. Although recommendations have been made for anticoagulant use for COVID-19, no guidelines have been specified.Case summaryWe describe four cases of critical COVID-19 with thrombosis detected by enhanced CT scan. The CT findings of all cases demonstrated typical findings of COVID-19 and pulmonary embolism or deep venous thrombus without critical exacerbation. Two patients died of respiratory failure due to COVID-19.DiscussionPrevious reports have suggested coagulopathy with thrombotic signs as the main pathological feature of COVID-19, but no previous reports have focused on coagulopathy evaluated by whole-body enhanced CT scan. Changes in hemostatic biomarkers, represented by an increase in D-dimer and fibrin/fibrinogen degradation products, indicated that the essence of coagulopathy was massive fibrin formation. Although there were no clinical symptoms related to their prognosis, critical COVID-19-induced systemic thrombus formation was observed.ConclusionsTherapeutic dose anticoagulants should be considered for critical COVID-19 because of induced coagulopathy, and aggressive follow-up by whole body enhanced CT scan for systemic venous thromboembolism (VTE) is necessary.

【 授权许可】

CC BY