Kanso Mohamad, Cardi Thomas, Marzak Halim, Schatz Alexandre, Faucher Loïc, Grunebaum Lélia, Morel Olivier, Jesel Laurence
Pôle d'Activité Médico-Chirurgicale Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital 67091, Strasbourg Cedex, France.
Eur Heart J Case Rep. 2020 Nov 24;4(6):1-4. doi: 10.1093/ehjcr/ytaa449. eCollection 2020 Dec.
Since the onset of the COVID-19 pandemic, several cardiovascular manifestations have been described. Among them, venous thromboembolism (VTE) seems to be one of the most frequent, particularly in intensive care unit patients. We report two cases of COVID-19 patients developing acute pulmonary embolism (PE) after discharge from a first hospitalization for pneumonia of moderate severity.
Two patients with positive RT-PCR test were initially hospitalized for non-severe COVID-19. Both received standard thromboprophylaxis during the index hospitalization and had no strong predisposing risk factors for VTE. Few days after discharge, they were both readmitted for worsening dyspnoea due to PE. One patient was positive for lupus anticoagulant.
Worsening respiratory status in COVID-19 patients must encourage physicians to search for PE since SARS-CoV-2 infection may act as a precipitant risk factor for VTE. Patients may thus require more aggressive and longer thromboprophylaxis after COVID-19 related hospitalization.
自新冠疫情爆发以来,已发现多种心血管表现。其中,静脉血栓栓塞症(VTE)似乎最为常见,尤其是在重症监护病房患者中。我们报告两例新冠患者,在首次因中度严重肺炎住院出院后发生急性肺栓塞(PE)。
两名RT-PCR检测呈阳性的患者最初因非重症新冠住院。两人在初次住院期间均接受了标准的血栓预防措施,且无VTE的强烈易感风险因素。出院几天后,两人均因PE导致呼吸困难加重而再次入院。一名患者狼疮抗凝物呈阳性。
新冠患者呼吸状况恶化必须促使医生排查PE,因为新冠病毒感染可能是VTE的诱发风险因素。因此,新冠相关住院后的患者可能需要更积极、更长时间的血栓预防措施。