Severe Spontaneous Hematomas in Patients Hospitalized with COVID-19
Objective. To describe the epidemiological, clinical, laboratory, and radiological characteristics, medical treatment, and outcomes of a case series of severe spontaneous hematoma in COVID-19. Material and Methods. This retrospective study included patients hospitalized for COVID-19 who were diagnos...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | International Journal of Clinical Practice |
| Online Access: | http://dx.doi.org/10.1155/2023/6668475 |
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| author | Silvia Otero-Rodriguez Cristina Guillen Maria Mataix Pilar Gonzalez-de-la-Aleja Elisabeth Cruces-Fuentes Alix Juliette Mantilla-Pinilla Oscar Moreno-Perez Rosario Sanchez-Martinez Esperanza Merino Jose-Manuel Ramos-Rincon |
| author_facet | Silvia Otero-Rodriguez Cristina Guillen Maria Mataix Pilar Gonzalez-de-la-Aleja Elisabeth Cruces-Fuentes Alix Juliette Mantilla-Pinilla Oscar Moreno-Perez Rosario Sanchez-Martinez Esperanza Merino Jose-Manuel Ramos-Rincon |
| author_sort | Silvia Otero-Rodriguez |
| collection | DOAJ |
| description | Objective. To describe the epidemiological, clinical, laboratory, and radiological characteristics, medical treatment, and outcomes of a case series of severe spontaneous hematoma in COVID-19. Material and Methods. This retrospective study included patients hospitalized for COVID-19 who were diagnosed with severe spontaneous bleeding complications by following a standardized treatment protocol that included computed tomography angiography (CTA) from 1 March 2020 to 28 February 2022. The main outcomes were embolization and all-cause mortality. Baseline variables were analyzed for their association with mortality using bivariable logistic regression, and results were expressed as odds ratios (OR) and 95% confidence intervals (CI). Results. In total, 2450 adults were hospitalized for COVID-19 in our center during the study period. 20 patients presented severe and spontaneous intramuscular bleeding (8.1 per 1000 COVID-19 admission vs. 0.47 per 1000 non-COVID-19 admissions, p<0.001); their median age was 68.5 years (interquartile range (IQR) 63, 80), they had high comorbidity (median Charlson comorbidity index 4.5), and 95% were receiving high doses of heparin. The median interval from COVID-19 symptoms to bleeding was 17 days (IQR 13, 24), and 70% reported cough as a previous symptom. Hypovolemic shock, hypotension, and abdominal pain were the most frequent symptoms of the hematoma. All presented decreased hemoglobin, and 95% required transfusion. Intramuscular hematoma occurred most frequently in the rectus sheath, iliopsoas compartment, and femoral-iliac compartment. All patients underwent embolization; mortality was 45%. We did not identify risk factors associated with an increased risk of death. Conclusion. Although severe bleeding is an uncommon complication of COVID-19, its prevalence is higher than in inpatients without COVID-19, it usually needs embolization, and it is associated with high mortality. |
| format | Article |
| id | doaj-art-fe433aba6fae43b38e2ef8db09701b4b |
| institution | Kabale University |
| issn | 1742-1241 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Clinical Practice |
| spelling | doaj-art-fe433aba6fae43b38e2ef8db09701b4b2025-08-20T03:25:45ZengWileyInternational Journal of Clinical Practice1742-12412023-01-01202310.1155/2023/6668475Severe Spontaneous Hematomas in Patients Hospitalized with COVID-19Silvia Otero-Rodriguez0Cristina Guillen1Maria Mataix2Pilar Gonzalez-de-la-Aleja3Elisabeth Cruces-Fuentes4Alix Juliette Mantilla-Pinilla5Oscar Moreno-Perez6Rosario Sanchez-Martinez7Esperanza Merino8Jose-Manuel Ramos-Rincon9Infectious Diseases UnitEndocrinology DepartmentIntensive Care UnitInfectious Diseases UnitRadiodiagnosis Department Alicante General University Hospital-Alicante Institute of Health and Biomedical Research (ISABIAL)Radiodiagnosis Department Alicante General University Hospital-Alicante Institute of Health and Biomedical Research (ISABIAL)Endocrinology DepartmentClinical Medicine DepartmentInfectious Diseases UnitClinical Medicine DepartmentObjective. To describe the epidemiological, clinical, laboratory, and radiological characteristics, medical treatment, and outcomes of a case series of severe spontaneous hematoma in COVID-19. Material and Methods. This retrospective study included patients hospitalized for COVID-19 who were diagnosed with severe spontaneous bleeding complications by following a standardized treatment protocol that included computed tomography angiography (CTA) from 1 March 2020 to 28 February 2022. The main outcomes were embolization and all-cause mortality. Baseline variables were analyzed for their association with mortality using bivariable logistic regression, and results were expressed as odds ratios (OR) and 95% confidence intervals (CI). Results. In total, 2450 adults were hospitalized for COVID-19 in our center during the study period. 20 patients presented severe and spontaneous intramuscular bleeding (8.1 per 1000 COVID-19 admission vs. 0.47 per 1000 non-COVID-19 admissions, p<0.001); their median age was 68.5 years (interquartile range (IQR) 63, 80), they had high comorbidity (median Charlson comorbidity index 4.5), and 95% were receiving high doses of heparin. The median interval from COVID-19 symptoms to bleeding was 17 days (IQR 13, 24), and 70% reported cough as a previous symptom. Hypovolemic shock, hypotension, and abdominal pain were the most frequent symptoms of the hematoma. All presented decreased hemoglobin, and 95% required transfusion. Intramuscular hematoma occurred most frequently in the rectus sheath, iliopsoas compartment, and femoral-iliac compartment. All patients underwent embolization; mortality was 45%. We did not identify risk factors associated with an increased risk of death. Conclusion. Although severe bleeding is an uncommon complication of COVID-19, its prevalence is higher than in inpatients without COVID-19, it usually needs embolization, and it is associated with high mortality.http://dx.doi.org/10.1155/2023/6668475 |
| spellingShingle | Silvia Otero-Rodriguez Cristina Guillen Maria Mataix Pilar Gonzalez-de-la-Aleja Elisabeth Cruces-Fuentes Alix Juliette Mantilla-Pinilla Oscar Moreno-Perez Rosario Sanchez-Martinez Esperanza Merino Jose-Manuel Ramos-Rincon Severe Spontaneous Hematomas in Patients Hospitalized with COVID-19 International Journal of Clinical Practice |
| title | Severe Spontaneous Hematomas in Patients Hospitalized with COVID-19 |
| title_full | Severe Spontaneous Hematomas in Patients Hospitalized with COVID-19 |
| title_fullStr | Severe Spontaneous Hematomas in Patients Hospitalized with COVID-19 |
| title_full_unstemmed | Severe Spontaneous Hematomas in Patients Hospitalized with COVID-19 |
| title_short | Severe Spontaneous Hematomas in Patients Hospitalized with COVID-19 |
| title_sort | severe spontaneous hematomas in patients hospitalized with covid 19 |
| url | http://dx.doi.org/10.1155/2023/6668475 |
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