Pulmonary embolism in a patient with COVID-19 pneumonia despite satisfying anticoagulation status
Journal
Macedonian Journal of Anesthesia
Date Issued
2022-12
Author(s)
Jovanoski M
Abstract
Introduction: COVID-19 disease is a disease related to many complications, some of them
are life threatening. Venous thromboembolism is one of the cardiovascular causes (the third in
mortality in the group of cardiovascular diseases), which can lead to serious morbidity and even
mortality.
Aim: To present the fact that a quality anticoagulation therapy is not always a 100 percent
safe mechanism of dealing with VTE.
Case Report: This case report is about a patient which was presented with a clinical
condition related to COVID-19 bilateral bronchopneumonia. As such, she was treated with all
the necessary medications, but after a VTE occurred as one of the complications, we had to
upgrade the doses of anticoagulation to a therapeutic status. The CT angiography showing lobar
and subsegmental pulmonary embolism was the gold standard to confirm the diagnosis. The
effect of the LWMH which was used for the VTE was controlled by measuring the anti-Xa
blood level. A further correction of the doses and types of antibiotics had to be done because of
medications related thrombocytopenia which made the condition even more difficult to fight
with.
Conclusion: Using the antiXa as a tool to control the anticoagulation status in VTE patients
can be a valuable thing to do. However, we must be always thorough in observing the clinical
condition of the patient and be aware of the complications which can happen.
are life threatening. Venous thromboembolism is one of the cardiovascular causes (the third in
mortality in the group of cardiovascular diseases), which can lead to serious morbidity and even
mortality.
Aim: To present the fact that a quality anticoagulation therapy is not always a 100 percent
safe mechanism of dealing with VTE.
Case Report: This case report is about a patient which was presented with a clinical
condition related to COVID-19 bilateral bronchopneumonia. As such, she was treated with all
the necessary medications, but after a VTE occurred as one of the complications, we had to
upgrade the doses of anticoagulation to a therapeutic status. The CT angiography showing lobar
and subsegmental pulmonary embolism was the gold standard to confirm the diagnosis. The
effect of the LWMH which was used for the VTE was controlled by measuring the anti-Xa
blood level. A further correction of the doses and types of antibiotics had to be done because of
medications related thrombocytopenia which made the condition even more difficult to fight
with.
Conclusion: Using the antiXa as a tool to control the anticoagulation status in VTE patients
can be a valuable thing to do. However, we must be always thorough in observing the clinical
condition of the patient and be aware of the complications which can happen.
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