Late diagnosis of COVID-19 in a 34-year-old man in a hypercoagulable state: A case report
Background: Late diagnosis of COVID-19 in young patients in a hypercoagulable state can cause a high mortality rate. Clinical manifestations of COVID-19 include respiratory and extrapulmonary symptoms such as a hypercoagulable state, increased transaminase enzymes, and multiple-organ failure. Case...
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| Format: | Article |
| Language: | English |
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Canadian Society of Respiratory Therapists
2022-04-01
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| Series: | Canadian Journal of Respiratory Therapy |
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| Online Access: | https://www.cjrt.ca/wp-content/uploads/cjrt-2021-028.pdf |
| _version_ | 1811241331397230592 |
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| author | Desdiani Desdiani |
| author_facet | Desdiani Desdiani |
| author_sort | Desdiani Desdiani |
| collection | DOAJ |
| description | Background: Late diagnosis of COVID-19 in young patients in a hypercoagulable state can cause a high mortality rate. Clinical manifestations of COVID-19 include respiratory and extrapulmonary symptoms such as a hypercoagulable state, increased transaminase enzymes, and multiple-organ failure.
Case and outcomes: A 34-year-old male presented to the emergency room after 3 days of high fever, weakness, and flatulence. The patient had
thrombocytopenia and elevated liver transaminase enzymes and was initially diagnosed with dengue hemorrhagic fever. He was given hydration intravenous fluids, oxygen, antipyretic, and hepatoprotector. On day 4, the patient was diagnosed with COVID-19 and received therapy to decrease the
Alanine transaminase and Aspartate transaminase levels. While waiting for outsourced D dimer and prothrombin time results, the patient was given
low molecular weight heparin (LMWH) on day 5. On day 13, his condition deteriorated with cephalgia and shortness of breath, but the patient’s family refused intubation. The chest CT scan revealed large ground-glass opacities in both lungs. The patient was given additional medications, such as Meropenem, Dexamethasone, and Remdesivir. On day 15, the patient passed away.
Discussion: Intermediate LMWH dosage seems to be associated with a lower mortality incidence than standard Deep Vein Thrombosis (DVT) prophylaxis in hospitalized COVID-19 patients. However, due to the late COVID-19 diagnosis, the patient was not given LMWH at the beginning of treatment.
Conclusion: A hypercoagulable state is partly responsible for the high mortality rate of COVID-19 patients. Early detection and management of the hypercoagulable state, including the use of LMWH, can decrease the severity of COVID-19 symptoms. |
| first_indexed | 2024-04-12T13:34:43Z |
| format | Article |
| id | doaj.art-831bb0abc0a3470d8c76b469ff3d0da0 |
| institution | Directory Open Access Journal |
| issn | 2368-6820 |
| language | English |
| last_indexed | 2024-04-12T13:34:43Z |
| publishDate | 2022-04-01 |
| publisher | Canadian Society of Respiratory Therapists |
| record_format | Article |
| series | Canadian Journal of Respiratory Therapy |
| spelling | doaj.art-831bb0abc0a3470d8c76b469ff3d0da02022-12-22T03:31:03ZengCanadian Society of Respiratory TherapistsCanadian Journal of Respiratory Therapy2368-68202022-04-0158495210.29390/cjrt-2021-028Late diagnosis of COVID-19 in a 34-year-old man in a hypercoagulable state: A case reportDesdiani DesdianiBackground: Late diagnosis of COVID-19 in young patients in a hypercoagulable state can cause a high mortality rate. Clinical manifestations of COVID-19 include respiratory and extrapulmonary symptoms such as a hypercoagulable state, increased transaminase enzymes, and multiple-organ failure. Case and outcomes: A 34-year-old male presented to the emergency room after 3 days of high fever, weakness, and flatulence. The patient had thrombocytopenia and elevated liver transaminase enzymes and was initially diagnosed with dengue hemorrhagic fever. He was given hydration intravenous fluids, oxygen, antipyretic, and hepatoprotector. On day 4, the patient was diagnosed with COVID-19 and received therapy to decrease the Alanine transaminase and Aspartate transaminase levels. While waiting for outsourced D dimer and prothrombin time results, the patient was given low molecular weight heparin (LMWH) on day 5. On day 13, his condition deteriorated with cephalgia and shortness of breath, but the patient’s family refused intubation. The chest CT scan revealed large ground-glass opacities in both lungs. The patient was given additional medications, such as Meropenem, Dexamethasone, and Remdesivir. On day 15, the patient passed away. Discussion: Intermediate LMWH dosage seems to be associated with a lower mortality incidence than standard Deep Vein Thrombosis (DVT) prophylaxis in hospitalized COVID-19 patients. However, due to the late COVID-19 diagnosis, the patient was not given LMWH at the beginning of treatment. Conclusion: A hypercoagulable state is partly responsible for the high mortality rate of COVID-19 patients. Early detection and management of the hypercoagulable state, including the use of LMWH, can decrease the severity of COVID-19 symptoms.https://www.cjrt.ca/wp-content/uploads/cjrt-2021-028.pdfcovid-19hypercoagulable statelate diagnosislmwhyoung patient |
| spellingShingle | Desdiani Desdiani Late diagnosis of COVID-19 in a 34-year-old man in a hypercoagulable state: A case report Canadian Journal of Respiratory Therapy covid-19 hypercoagulable state late diagnosis lmwh young patient |
| title | Late diagnosis of COVID-19 in a 34-year-old man in a hypercoagulable state: A case report |
| title_full | Late diagnosis of COVID-19 in a 34-year-old man in a hypercoagulable state: A case report |
| title_fullStr | Late diagnosis of COVID-19 in a 34-year-old man in a hypercoagulable state: A case report |
| title_full_unstemmed | Late diagnosis of COVID-19 in a 34-year-old man in a hypercoagulable state: A case report |
| title_short | Late diagnosis of COVID-19 in a 34-year-old man in a hypercoagulable state: A case report |
| title_sort | late diagnosis of covid 19 in a 34 year old man in a hypercoagulable state a case report |
| topic | covid-19 hypercoagulable state late diagnosis lmwh young patient |
| url | https://www.cjrt.ca/wp-content/uploads/cjrt-2021-028.pdf |
| work_keys_str_mv | AT desdianidesdiani latediagnosisofcovid19ina34yearoldmaninahypercoagulablestateacasereport |