Tag Archives: COVID-19

Right Heart Thrombus in an Adult COVID-19 Patient: A Case Report

Enrico Merlo, Giuseppe Grutta, Ivo Tiberio, Gabriele Martelli

Intensive Care Unit “U.O.C. Anestesia e Rianimazione” Department of Medicine (DIMED) Padua University Hospital, Padua, Italy

DOI: 10.2478/jccm-2020-0039

Introduction: Right heart thrombus (RiHTh) can be considered a rare and severe condition associated with thromboembolic phenomena. A case is described of a COVID-19 patient presenting with an isolated thrombus in the right ventricle.
Case presentation: An 80-years-old Caucasian male was admitted in an intensive care unit (ICU) for COVID-19 related acute respiratory distress syndrome. The patient showed signs of hemodynamic instability, elevated cardiac troponin I and altered coagulation. On further assessment, a thrombotic mass near the apex of the right ventricle was detected. Moreover, the apex and the anteroseptal wall of the right ventricle appeared akinetic. Following the administration of a therapeutic dose of unfractionated heparin over a forty-eight hour period, re-evaluation of the right chambers showed that the thrombotic mass had resolved entirely.
Conclusion: COVID-19 patients could constitute a population at risk of RiHTh. Routine use of echocardiography and a multidisciplinary approach can improve the management of this condition.

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Anticoagulation in COVID – 19: An Update

Nishant R Tiwari1, Khalid I Khatib2, Subhal B Dixit3, Prajay K Rathore4, Sameer Melinkeri5, Abhijeet Ganapule6, Kapil S Borawake7, Ujwala Mhatre8

1 Byramjee Jeejeebhoy Medical College and Sassoon General Hospital, Pune, Maharashtra, India
2 Smt Kashibai Navale Medical College and General Hospital, Pune, India
3 Sanjeevan Hospital, Pune, India
4 Danbury Hospital, Danbury, USA
5 Deenanath Mangeshkar Hospital and Research Centre, Pune, India
6 Niche Hematology Care, Kolhapur, India
7 Prayag Hospital, Pune, India
8 Nanavati Hospital, Mumbai, India

DOI: 10.2478/jccm-2020-0033

The novel coronavirus disease, 2019 (COVID – 19) evolved as an unprecedented pandemic. The severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2) infection has been associated with significantly deranged coagulation parameters and increased incidence of thrombotic events. Deranged coagulation parameters, such as D-dimers and fibrin degradation products, can indicate a poor prognosis, and their measurement will help stratify the patients according to the disease severity, need of intensive care unit admission, and prediction of the clinical course. Gaps in understanding the natural history of the disease cause difficulties in tailoring therapies and optimizing the management of patients. Lack of specific treatment further complicates this situation. While thrombotic events can cause significant morbidity and mortality in patients, a focused approach to the prevention and treatment of venous thromboembolism (VTE) can, to a great extent, decrease the disease burden caused by thrombotic diseases. Pharmacological prophylactic anticoagulants and mechanical therapies such as pneumatic compression devices can help prevent venous thromboembolism and other thrombotic events. Thrombotic events due to COVID-19, their prevention and management, are the focus of this paper, with the prospect of providing insights into this relatively unexplored area.

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