An Experience of Multiple Hematomas in a Coronavirus Disease-19 Patient Administered with ART-123 and Heparin

Anticoagulant therapy for patients with severe coronavirus disease (COVID-19) pneumonia is considered to improve the hypercoagulable and inflammatory state. However, bleeding complications should also be considered. A 77-year-old man with a history of falls was diagnosed with COVID-19. Owing to his...

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Bibliographic Details
Published in:Open access emergency medicine 2021-01, Vol.13, p.207-211
Main Authors: Shiraki, Hideto, Morishita, Koji, Kishino, Mitsuhiro, Nakatsutsumi, Keita, Kimura, Koichiro, Shirai, Tsuyoshi, Ishizuka, Masahiro, Miyazaki, Yasunari, Aiboshi, Junichi, Otomo, Yasuhiro
Format: Article
Language:English
Subjects:
anticoagulation
Atrial fibrillation
Care and treatment
Case Report
complication
Coronaviruses
COVID-19
Diagnostic imaging
Health aspects
hematoma
Heparin
Medical imaging
Mortality
tae
Veins & arteries
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Summary:Anticoagulant therapy for patients with severe coronavirus disease (COVID-19) pneumonia is considered to improve the hypercoagulable and inflammatory state. However, bleeding complications should also be considered. A 77-year-old man with a history of falls was diagnosed with COVID-19. Owing to his severe condition, he was intubated and transferred to our hospital for intensive care. Favipiravir, tocilizumab, unfractionated heparin, and ART-123 were administered to treat COVID-19 and manage the antithrombotic prophylaxis for paroxysmal atrial fibrillation (Af). On the 6th day after admission, a hematoma was noted on the left chest wall. Computed tomography (CT) revealed multiple hematomas, including hematomas on his chest wall and obturatorius internus muscle. Emergency angiography transcatheter embolization (TAE) was performed. The patient was transferred to another hospital 23 days after TAE, without complications. Our findings show that anticoagulation therapy and a history of falls induced multiple hematomas in a COVID-19 patient and that the condition was managed with TAE. When anticoagulants are considered in the management of Af and COVID-19 associated coagulopathy, it is necessary to closely monitor potential bleeding complications.
ISSN:1179-1500
1179-1500
DOI:10.2147/OAEM.S302732