An Experience of Multiple Hematomas in a Coronavirus Disease-19 Patient Administered with ART-123 and Heparin
Hideto Shiraki,1 Koji Morishita,1 Mitsuhiro Kishino,2 Keita Nakatsutsumi,1 Koichiro Kimura,2 Tsuyoshi Shirai,3 Masahiro Ishizuka,3 Yasunari Miyazaki,3 Junichi Aiboshi,1 Yasuhiro Otomo1 1Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University Hospital of Medicine,...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2021-05-01
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| Series: | Open Access Emergency Medicine |
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| Online Access: | https://www.dovepress.com/an-experience-of-multiple-hematomas-in-a-coronavirus-disease-19-patien-peer-reviewed-fulltext-article-OAEM |
| _version_ | 1819094083078979584 |
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| author | Shiraki H Morishita K Kishino M Nakatsutsumi K Kimura K Shirai T Ishizuka M Miyazaki Y Aiboshi J Otomo Y |
| author_facet | Shiraki H Morishita K Kishino M Nakatsutsumi K Kimura K Shirai T Ishizuka M Miyazaki Y Aiboshi J Otomo Y |
| author_sort | Shiraki H |
| collection | DOAJ |
| description | Hideto Shiraki,1 Koji Morishita,1 Mitsuhiro Kishino,2 Keita Nakatsutsumi,1 Koichiro Kimura,2 Tsuyoshi Shirai,3 Masahiro Ishizuka,3 Yasunari Miyazaki,3 Junichi Aiboshi,1 Yasuhiro Otomo1 1Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan; 2Department of Diagnostic Radiology, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan; 3Department of Respiratory Medicine, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, JapanCorrespondence: Koji MorishitaDepartment of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, JapanTel +81-3-3813-6111Fax +81-3-5803-0137Email morishita.accm@tmd.ac.jpBackground: 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.Case Presentation: 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.Conclusion: 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.Keywords: anticoagulation, complication, COVID-19, hematoma, TAE |
| first_indexed | 2024-12-21T23:21:46Z |
| format | Article |
| id | doaj.art-4800603f0d2f4aa0984327f59cb30d9f |
| institution | Directory Open Access Journal |
| issn | 1179-1500 |
| language | English |
| last_indexed | 2024-12-21T23:21:46Z |
| publishDate | 2021-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Open Access Emergency Medicine |
| spelling | doaj.art-4800603f0d2f4aa0984327f59cb30d9f2022-12-21T18:46:46ZengDove Medical PressOpen Access Emergency Medicine1179-15002021-05-01Volume 1320721165055An Experience of Multiple Hematomas in a Coronavirus Disease-19 Patient Administered with ART-123 and HeparinShiraki HMorishita KKishino MNakatsutsumi KKimura KShirai TIshizuka MMiyazaki YAiboshi JOtomo YHideto Shiraki,1 Koji Morishita,1 Mitsuhiro Kishino,2 Keita Nakatsutsumi,1 Koichiro Kimura,2 Tsuyoshi Shirai,3 Masahiro Ishizuka,3 Yasunari Miyazaki,3 Junichi Aiboshi,1 Yasuhiro Otomo1 1Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan; 2Department of Diagnostic Radiology, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan; 3Department of Respiratory Medicine, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, JapanCorrespondence: Koji MorishitaDepartment of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, JapanTel +81-3-3813-6111Fax +81-3-5803-0137Email morishita.accm@tmd.ac.jpBackground: 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.Case Presentation: 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.Conclusion: 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.Keywords: anticoagulation, complication, COVID-19, hematoma, TAEhttps://www.dovepress.com/an-experience-of-multiple-hematomas-in-a-coronavirus-disease-19-patien-peer-reviewed-fulltext-article-OAEManticoagulationcomplicationcovid-19hematomatae |
| spellingShingle | Shiraki H Morishita K Kishino M Nakatsutsumi K Kimura K Shirai T Ishizuka M Miyazaki Y Aiboshi J Otomo Y An Experience of Multiple Hematomas in a Coronavirus Disease-19 Patient Administered with ART-123 and Heparin Open Access Emergency Medicine anticoagulation complication covid-19 hematoma tae |
| title | An Experience of Multiple Hematomas in a Coronavirus Disease-19 Patient Administered with ART-123 and Heparin |
| title_full | An Experience of Multiple Hematomas in a Coronavirus Disease-19 Patient Administered with ART-123 and Heparin |
| title_fullStr | An Experience of Multiple Hematomas in a Coronavirus Disease-19 Patient Administered with ART-123 and Heparin |
| title_full_unstemmed | An Experience of Multiple Hematomas in a Coronavirus Disease-19 Patient Administered with ART-123 and Heparin |
| title_short | An Experience of Multiple Hematomas in a Coronavirus Disease-19 Patient Administered with ART-123 and Heparin |
| title_sort | experience of multiple hematomas in a coronavirus disease 19 patient administered with art 123 and heparin |
| topic | anticoagulation complication covid-19 hematoma tae |
| url | https://www.dovepress.com/an-experience-of-multiple-hematomas-in-a-coronavirus-disease-19-patien-peer-reviewed-fulltext-article-OAEM |
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