COVID-19 pneumonia is one of the diseases that can cause hypercoagulability. It is not uncommon to encounter arterial or venous thromboembolic events during COVID-19 infection. In this case, we wanted to discuss a case of a pulmonary embolism due to COVID-19 infection, which developed despite the usage of therapeutic dosage of anticoagulants. A 41-year-old male patient with a known diabetes mellitus was admitted to our clinic with complaints of cough and headache. The patient was found to be COVID-19 positive. Along with steroid treatment, 2x6,000 IU enoxaparin treatment was initiated for the patient. He developed sudden respiratory distress and showed an increase in oxygen demand. D-dimer value increased abruptly to 35.2 mg/L. Pulmonary CT angiography showed multiple bilateral subsegmental pulmonary embolisms. Since COVID-19 infection can cause arterial and venous thromboembolic events in patients following up with COVID-19 pneumonia, prophylactic anticoagulation should be initiated in hospitalized patients. Attention should be paid to signs of bleeding, and dose adjustment should be made by monitoring coagulation parameters.
Panigada M, Bottino N, Tagliabue P, Grasselli G, Novembrino C, Chantarangkul V, Pesenti A, Peyvandi F, Tripodi A. Hypercoagulability of COVID-19 patients in intensive care unit: A report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost. 2020 Jul;18(7):1738-42. doi: 10.1111/jth.14850.
Maier CL, Truong AD, Auld SC, Polly DM, Tanksley CL, Duncan A. COVID-19- associated hyperviscosity: a link between inflammation and thrombophilia? Lancet. 2020 Jun 6;395(10239):1758-9. doi: 10.1016/S0140- 6736(20)31209-5.
Mansory EM, Srigunapalan S, Lazo-Langner A. Venous thromboembolism in hospitalized critical and noncritical COVID-19 patients: A systematic review and meta-analysis. TH Open. 2021 Jul 6;5(3):e286-e294. doi: 10.1055/s-0041-1730967.
Kollias A, Kyriakoulis KG, Lagou S, Kontopantelis E, Stergiou GS, Syrigos K. Venous thromboembolism in COVID-19: A systematic review and meta-analysis. Vasc Med. 2021 Aug;26(4):415-25. doi: 10.1177/1358863X21995566.
Dolhnikoff M, Duarte-Neto AN, de Almeida Monteiro RA, da Silva LFF, de Oliveira EP, Saldiva PHN, Mauad T, Negri EM. Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. J Thromb Haemost. 2020 Jun;18(6):1517-9. doi: 10.1111/jth.14844.
Panigada M, Bottino N, Tagliabue P, Grasselli G, Novembrino C, Chantarangkul V, Pesenti A, Peyvandi F, Tripodi A. Hypercoagulability of COVID-19 patients in intensive care unit: A report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost. 2020 Jul;18(7):1738-42. doi: 10.1111/jth.14850.
Maier CL, Truong AD, Auld SC, Polly DM, Tanksley CL, Duncan A. COVID-19- associated hyperviscosity: a link between inflammation and thrombophilia? Lancet. 2020 Jun 6;395(10239):1758-9. doi: 10.1016/S0140- 6736(20)31209-5.
Mansory EM, Srigunapalan S, Lazo-Langner A. Venous thromboembolism in hospitalized critical and noncritical COVID-19 patients: A systematic review and meta-analysis. TH Open. 2021 Jul 6;5(3):e286-e294. doi: 10.1055/s-0041-1730967.
Kollias A, Kyriakoulis KG, Lagou S, Kontopantelis E, Stergiou GS, Syrigos K. Venous thromboembolism in COVID-19: A systematic review and meta-analysis. Vasc Med. 2021 Aug;26(4):415-25. doi: 10.1177/1358863X21995566.
Dolhnikoff M, Duarte-Neto AN, de Almeida Monteiro RA, da Silva LFF, de Oliveira EP, Saldiva PHN, Mauad T, Negri EM. Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. J Thromb Haemost. 2020 Jun;18(6):1517-9. doi: 10.1111/jth.14844.
Gökmen İB, Yiğit SE, Okuturlar Y, Köksal İ (April 1, 2022) Pulmonary Embolism Developing Despite the Use of Anticoagulants in Covid-19 Pneumonia: A case report. Turkish Journal of Internal Medicine 4 160–163.
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