Spontaneous Hematomas in COVID-19 Patients on Low-Molecular-Weight Heparin

Background: COVID-19 patients are at increased risk of coagulopathy. This coagulopathy may be due to a severe pro-inflammatory state (cytokine storm) and/or by viral sepsis. This can sometimes lead to consumption coagulopathy and decreased platelet count, leading to increased risk of bleeding and ma...

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Main Authors: Hitesh Taleja, Vipin Venugopal Nair, Sunanda Yadav, Raghavendra Venkatnarayanan, Nilanjan Roy, Pankaj Rao
Format: Article
Language:English
Published: Knowledge E 2021-09-01
Series:Dubai Medical Journal
Subjects:
Online Access:https://www.karger.com/Article/FullText/518931
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author Hitesh Taleja
Vipin Venugopal Nair
Sunanda Yadav
Raghavendra Venkatnarayanan
Nilanjan Roy
Pankaj Rao
author_facet Hitesh Taleja
Vipin Venugopal Nair
Sunanda Yadav
Raghavendra Venkatnarayanan
Nilanjan Roy
Pankaj Rao
author_sort Hitesh Taleja
collection DOAJ
description Background: COVID-19 patients are at increased risk of coagulopathy. This coagulopathy may be due to a severe pro-inflammatory state (cytokine storm) and/or by viral sepsis. This can sometimes lead to consumption coagulopathy and decreased platelet count, leading to increased risk of bleeding and may manifest like hematomas in atypical locations. These bleeding manifestations may be spontaneous or can be induced by even minor trauma. Cases: It is a single-center retrospective analysis. Four patients with a confirmed diagnosis of COVID-19 depicting increased risk of bleeding manifestations were included. Patients in our study were managed as per guidelines recommended by the Ministry of Health and Family Welfare Directorate General of Health Services, Government of India. Results: All patients were male. The mean age was 56 ± 18.64 years. One patient was managed conservatively with discontinuation of anticoagulants, volume resuscitation, and transfusion of blood products. Drainage with incision was done for 2 patients. One was managed with pigtail drainage. Conclusion: The effect of anticoagulants given in therapy and their varied presentations are discussed in this article. The article concludes that we need vigilant observation to identify this complication in the early period, resulting in successful management.
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spelling doaj-art-50dcd83df9ad47d3ab01313b7beefcc82025-08-20T02:58:07ZengKnowledge EDubai Medical Journal2571-726X2021-09-014328529010.1159/000518931518931Spontaneous Hematomas in COVID-19 Patients on Low-Molecular-Weight HeparinHitesh TalejaVipin Venugopal Nairhttps://orcid.org/0000-0001-6903-6368Sunanda YadavRaghavendra VenkatnarayananNilanjan RoyPankaj RaoBackground: COVID-19 patients are at increased risk of coagulopathy. This coagulopathy may be due to a severe pro-inflammatory state (cytokine storm) and/or by viral sepsis. This can sometimes lead to consumption coagulopathy and decreased platelet count, leading to increased risk of bleeding and may manifest like hematomas in atypical locations. These bleeding manifestations may be spontaneous or can be induced by even minor trauma. Cases: It is a single-center retrospective analysis. Four patients with a confirmed diagnosis of COVID-19 depicting increased risk of bleeding manifestations were included. Patients in our study were managed as per guidelines recommended by the Ministry of Health and Family Welfare Directorate General of Health Services, Government of India. Results: All patients were male. The mean age was 56 ± 18.64 years. One patient was managed conservatively with discontinuation of anticoagulants, volume resuscitation, and transfusion of blood products. Drainage with incision was done for 2 patients. One was managed with pigtail drainage. Conclusion: The effect of anticoagulants given in therapy and their varied presentations are discussed in this article. The article concludes that we need vigilant observation to identify this complication in the early period, resulting in successful management.https://www.karger.com/Article/FullText/518931covid-19anticoagulantshematomasurgical intervention
spellingShingle Hitesh Taleja
Vipin Venugopal Nair
Sunanda Yadav
Raghavendra Venkatnarayanan
Nilanjan Roy
Pankaj Rao
Spontaneous Hematomas in COVID-19 Patients on Low-Molecular-Weight Heparin
Dubai Medical Journal
covid-19
anticoagulants
hematoma
surgical intervention
title Spontaneous Hematomas in COVID-19 Patients on Low-Molecular-Weight Heparin
title_full Spontaneous Hematomas in COVID-19 Patients on Low-Molecular-Weight Heparin
title_fullStr Spontaneous Hematomas in COVID-19 Patients on Low-Molecular-Weight Heparin
title_full_unstemmed Spontaneous Hematomas in COVID-19 Patients on Low-Molecular-Weight Heparin
title_short Spontaneous Hematomas in COVID-19 Patients on Low-Molecular-Weight Heparin
title_sort spontaneous hematomas in covid 19 patients on low molecular weight heparin
topic covid-19
anticoagulants
hematoma
surgical intervention
url https://www.karger.com/Article/FullText/518931
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AT sunandayadav spontaneoushematomasincovid19patientsonlowmolecularweightheparin
AT raghavendravenkatnarayanan spontaneoushematomasincovid19patientsonlowmolecularweightheparin
AT nilanjanroy spontaneoushematomasincovid19patientsonlowmolecularweightheparin
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