Chowdhry Erum, Moshman Jennifer, Carroll Stacey
Family Medicine, University of Nevada, Reno School of Medicine, Reno, USA.
Internal Medicine, Providence Newberg Medical Center, Newberg, USA.
Cureus. 2021 Sep 25;13(9):e18265. doi: 10.7759/cureus.18265. eCollection 2021 Sep.
Mechanisms of COVID-19 coagulopathy have been speculated and are not definitively understood; the current speculation is that there is elaborate crosstalk between the inflammatory and hemostatic systems which contributes to the overall increased thrombotic risk in the setting of COVID-19 resulting in a hypercoagulable state. A few documented reports regarding cases of apparent heparin resistance in patients with COVID-19 with complications of thromboembolic events occurring in the setting of heparin anticoagulation have been described. This phenomenon of heparin resistance has been observed in patients with active, severe COVID-19 infection. However, we describe a unique case of a patient who had recovered from a recent, mild COVID-19 infection that did not require hospitalization and presented with acute limb ischemia and demonstrated heparin resistance. The patient was managed by specialists in vascular surgery, intensivists, cardiologists, hematology, and physical medicine and rehabilitation (PMR). We present the case of a patient who had successfully recovered from COVID-19 yet demonstrated post-COVID-19 complications related to coagulopathy and heparin resistance.
新型冠状病毒肺炎（COVID-19）凝血病的机制已被推测，但尚未完全明确；目前的推测是，炎症系统和止血系统之间存在复杂的相互作用，这导致了COVID-19患者整体血栓形成风险增加，从而引发高凝状态。已有一些关于COVID-19患者在肝素抗凝治疗过程中发生血栓栓塞事件并发症时出现明显肝素抵抗病例的文献报道。在活动性、重症COVID-19感染患者中观察到了这种肝素抵抗现象。然而，我们描述了一例独特的病例，该患者近期从轻度COVID-19感染中康复，无需住院治疗，但出现了急性肢体缺血，并表现出肝素抵抗。该患者由血管外科专家、重症监护医生、心脏病专家、血液科医生以及物理医学与康复（PMR）专家进行治疗。我们报告了一例成功从COVID-19中康复，但仍出现与凝血病和肝素抵抗相关的COVID-19后并发症的患者病例。
