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Pulmonary embolism in patients with COVID-19 pneumonia on adequate oral anticoagulation

Thrombotic complications are common in patients with severe COVID-19 pneumonia with important consequences on the diagnostic and therapeutic management. We report a consecutive series of five patients on long-term oral anticoagulation therapy who presented to our hospital for severe COVID-19 pneumon...

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Autores principales: Di Tano, Giuseppe, Dede, Meghi, Pellicelli, Irene, Martinelli, Enrico, Moschini, Luigi, Calvaruso, Elva, Danzi, Gian Battista
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8549588/
https://www.ncbi.nlm.nih.gov/pubmed/34708314
http://dx.doi.org/10.1007/s11239-021-02589-y
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author Di Tano, Giuseppe
Dede, Meghi
Pellicelli, Irene
Martinelli, Enrico
Moschini, Luigi
Calvaruso, Elva
Danzi, Gian Battista
author_facet Di Tano, Giuseppe
Dede, Meghi
Pellicelli, Irene
Martinelli, Enrico
Moschini, Luigi
Calvaruso, Elva
Danzi, Gian Battista
author_sort Di Tano, Giuseppe
collection PubMed
description Thrombotic complications are common in patients with severe COVID-19 pneumonia with important consequences on the diagnostic and therapeutic management. We report a consecutive series of five patients on long-term oral anticoagulation therapy who presented to our hospital for severe COVID-19 pneumonia associated with segmental acute pulmonary embolism despite adherence to therapy and with an adequate anticoagulant range at the time of the event. Four patients were receiving a direct oral anticoagulant (two with edoxaban, one with rivaroxaban and one with apixaban) and one patient a vitamin K antagonist. No significant thrombotic risk factors, active cancer, or detectable venous thromboembolism were present. In all cases, elevated d-dimer and fibrinogen levels with a parallel rise in markers of inflammation were documented. The combination of these findings seems to support the hypothesis that considers the local vascular damage determined by severe viral infection as the main trigger of thrombi detected in the lungs, rather than emboli from peripheral veins.
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spelling pubmed-85495882021-10-27 Pulmonary embolism in patients with COVID-19 pneumonia on adequate oral anticoagulation Di Tano, Giuseppe Dede, Meghi Pellicelli, Irene Martinelli, Enrico Moschini, Luigi Calvaruso, Elva Danzi, Gian Battista J Thromb Thrombolysis Article Thrombotic complications are common in patients with severe COVID-19 pneumonia with important consequences on the diagnostic and therapeutic management. We report a consecutive series of five patients on long-term oral anticoagulation therapy who presented to our hospital for severe COVID-19 pneumonia associated with segmental acute pulmonary embolism despite adherence to therapy and with an adequate anticoagulant range at the time of the event. Four patients were receiving a direct oral anticoagulant (two with edoxaban, one with rivaroxaban and one with apixaban) and one patient a vitamin K antagonist. No significant thrombotic risk factors, active cancer, or detectable venous thromboembolism were present. In all cases, elevated d-dimer and fibrinogen levels with a parallel rise in markers of inflammation were documented. The combination of these findings seems to support the hypothesis that considers the local vascular damage determined by severe viral infection as the main trigger of thrombi detected in the lungs, rather than emboli from peripheral veins. Springer US 2021-10-27 2022 /pmc/articles/PMC8549588/ /pubmed/34708314 http://dx.doi.org/10.1007/s11239-021-02589-y Text en © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Article
Di Tano, Giuseppe
Dede, Meghi
Pellicelli, Irene
Martinelli, Enrico
Moschini, Luigi
Calvaruso, Elva
Danzi, Gian Battista
Pulmonary embolism in patients with COVID-19 pneumonia on adequate oral anticoagulation
title Pulmonary embolism in patients with COVID-19 pneumonia on adequate oral anticoagulation
title_full Pulmonary embolism in patients with COVID-19 pneumonia on adequate oral anticoagulation
title_fullStr Pulmonary embolism in patients with COVID-19 pneumonia on adequate oral anticoagulation
title_full_unstemmed Pulmonary embolism in patients with COVID-19 pneumonia on adequate oral anticoagulation
title_short Pulmonary embolism in patients with COVID-19 pneumonia on adequate oral anticoagulation
title_sort pulmonary embolism in patients with covid-19 pneumonia on adequate oral anticoagulation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8549588/
https://www.ncbi.nlm.nih.gov/pubmed/34708314
http://dx.doi.org/10.1007/s11239-021-02589-y
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