Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospital

Background: Haemorrhages in coronavirus disease 2019 (COVID-19) patients require proper knowledge and management. Objectives: To highlight the characteristics of haemorrhages in patients with COVID-19 infection. Method: A retrospective study examined CT scans performed over a 13-month period in pa...

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Main Authors: Mirko Trentadue, Plinio Calligaro, Gianluigi Lazzarini, Fabio Bonomi Boseggia, Elena Residori, Jennifer Hu, Silvana Vanti, Linda Lillo, Giovanna Varischi, Roberto Cerini
Format: Article
Language:English
Published: AOSIS 2022-10-01
Series:South African Journal of Radiology
Subjects:
Online Access:https://sajr.org.za/index.php/sajr/article/view/2509
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author Mirko Trentadue
Plinio Calligaro
Gianluigi Lazzarini
Fabio Bonomi Boseggia
Elena Residori
Jennifer Hu
Silvana Vanti
Linda Lillo
Giovanna Varischi
Roberto Cerini
author_facet Mirko Trentadue
Plinio Calligaro
Gianluigi Lazzarini
Fabio Bonomi Boseggia
Elena Residori
Jennifer Hu
Silvana Vanti
Linda Lillo
Giovanna Varischi
Roberto Cerini
author_sort Mirko Trentadue
collection DOAJ
description Background: Haemorrhages in coronavirus disease 2019 (COVID-19) patients require proper knowledge and management. Objectives: To highlight the characteristics of haemorrhages in patients with COVID-19 infection. Method: A retrospective study examined CT scans performed over a 13-month period in patients hospitalised with COVID-19 infection to determine those who developed spontaneous bleeding. The authors also investigated correlations between the bleeding events and the patients’ characteristics. Results: Haemorrhages occurred in 2.22% (31/1396) of patients hospitalised with COVID-19 infection (7.88%, 19/241 in the intensive care unit). Bleeding, major in most cases, occurred in anticoagulated patients, especially males with multiple comorbidities, aged between 60 and 79 years and mainly appeared in a single anatomical region (especially retroperitoneal), with the most voluminous in the chest wall. The complication was diagnosed on average 16.7 days after admission and occurred predominantly in critically ill patients undergoing invasive ventilation and pronation-supination cycles. In just under half of the cases, the haematomas were active, and in these cases, mainly with a single contrast blush and with earlier onset after the start of anticoagulation than in non-active bleeding. Major bleeding was also earlier in the presence of multiple morbidity. The vast majority of patients were treated conservatively and survived. Conclusion: At COVID-19 hospital centres, it is advisable that there is knowledge of such a complication for which CT imaging is essential for diagnosis and proper management. Although some authors have expressed doubts about anticoagulant treatment in patients with COVID-19, the bleeding complication in this study did not significantly affect the outcome. Contribution: Spontaneous haemorrhage did not significantly affect the outcome in this series.
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spelling doaj.art-4dd42ea8fe5849f8a156762c3e04bc8f2022-12-22T03:56:19ZengAOSISSouth African Journal of Radiology1027-202X2078-67782022-10-01261e1e910.4102/sajr.v26i1.25091205Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospitalMirko Trentadue0Plinio Calligaro1Gianluigi Lazzarini2Fabio Bonomi Boseggia3Elena Residori4Jennifer Hu5Silvana Vanti6Linda Lillo7Giovanna Varischi8Roberto Cerini9Radiology Unit, M. Magalini Hospital, AULSS 9 Scaligera, Villafranca di VeronaIntensive Care Unit, M. Magalini Hospital, AULSS 9 Scaligera, Villafranca di VeronaIndependent Researcher, Occupational Medicine Specialist, Peschiera del GardaRadiology Unit, M. Magalini Hospital, AULSS 9 Scaligera, Villafranca di VeronaRadiology Unit, M. Magalini Hospital, AULSS 9 Scaligera, Villafranca di VeronaRadiology Unit, M. Magalini Hospital, AULSS 9 Scaligera, Villafranca di VeronaRadiology Unit, M. Magalini Hospital, AULSS 9 Scaligera, Villafranca di VeronaOccupational Medicine Service, Palazzo della Sanità, AULSS 9 Scaligera, VeronaHospital Medical Management - District 4, Professional Staff Organization, AULSS 9 Scaligera, Villafranca di VeronaRadiology Unit, M. Magalini Hospital, AULSS 9 Scaligera, Villafranca di VeronaBackground: Haemorrhages in coronavirus disease 2019 (COVID-19) patients require proper knowledge and management. Objectives: To highlight the characteristics of haemorrhages in patients with COVID-19 infection. Method: A retrospective study examined CT scans performed over a 13-month period in patients hospitalised with COVID-19 infection to determine those who developed spontaneous bleeding. The authors also investigated correlations between the bleeding events and the patients’ characteristics. Results: Haemorrhages occurred in 2.22% (31/1396) of patients hospitalised with COVID-19 infection (7.88%, 19/241 in the intensive care unit). Bleeding, major in most cases, occurred in anticoagulated patients, especially males with multiple comorbidities, aged between 60 and 79 years and mainly appeared in a single anatomical region (especially retroperitoneal), with the most voluminous in the chest wall. The complication was diagnosed on average 16.7 days after admission and occurred predominantly in critically ill patients undergoing invasive ventilation and pronation-supination cycles. In just under half of the cases, the haematomas were active, and in these cases, mainly with a single contrast blush and with earlier onset after the start of anticoagulation than in non-active bleeding. Major bleeding was also earlier in the presence of multiple morbidity. The vast majority of patients were treated conservatively and survived. Conclusion: At COVID-19 hospital centres, it is advisable that there is knowledge of such a complication for which CT imaging is essential for diagnosis and proper management. Although some authors have expressed doubts about anticoagulant treatment in patients with COVID-19, the bleeding complication in this study did not significantly affect the outcome. Contribution: Spontaneous haemorrhage did not significantly affect the outcome in this series.https://sajr.org.za/index.php/sajr/article/view/2509covid-19bleedinghaemorrhagehaematomaretroperitoneum
spellingShingle Mirko Trentadue
Plinio Calligaro
Gianluigi Lazzarini
Fabio Bonomi Boseggia
Elena Residori
Jennifer Hu
Silvana Vanti
Linda Lillo
Giovanna Varischi
Roberto Cerini
Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospital
South African Journal of Radiology
covid-19
bleeding
haemorrhage
haematoma
retroperitoneum
title Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospital
title_full Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospital
title_fullStr Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospital
title_full_unstemmed Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospital
title_short Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospital
title_sort spontaneous bleeding in covid 19 a retrospective experience of an italian covid 19 hospital
topic covid-19
bleeding
haemorrhage
haematoma
retroperitoneum
url https://sajr.org.za/index.php/sajr/article/view/2509
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