1Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
2Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Am J Trop Med Hyg. 2021 Jan 13;104(3):1018-1021. doi: 10.4269/ajtmh.20-1507.
Anticoagulation plays a major role in reducing the risk of systematic thrombosis in patients with severe COVID-19. Serious hemorrhagic complications, such as intracranial hemorrhage, have also been recognized. However, intra-abdominal hemorrhage is under-recognized because of its rare occurrence, despite high mortality. Here, we discuss two cases of spontaneous iliopsoas hematoma (IPH) likely caused by anticoagulants during the clinical course of COVID-19. We also explored published case reports to identify clinical characteristics of IPH in COVID-19 patients. The use of anticoagulants may increase the risk of lethal IPH among COVID-19 patients becsuse of scarce data on optimal dosage and adequate monitoring of anticoagulant effects. Rapid diagnosis and timely intervention are crucial to ensure good patient outcomes.
抗凝在降低重症 COVID-19 患者系统性血栓风险方面发挥着重要作用。但也已认识到严重出血并发症，如颅内出血。然而，尽管其死亡率高，但由于其罕见发生，腹内出血仍未得到充分认识。在这里，我们讨论了 COVID-19 病程中抗凝剂可能导致的两例自发性髂腰肌血肿（IPH）病例。我们还查阅了已发表的病例报告，以确定 COVID-19 患者中 IPH 的临床特征。由于缺乏关于最佳剂量和充分监测抗凝效果的相关数据，抗凝剂的使用可能会增加 COVID-19 患者发生致命性 IPH 的风险。
