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01 April 2021: Articles

Thromboelastography-Guided Anticoagulant Therapy for the Double Hazard of Thrombohemorrhagic Events in COVID-19: A Report of 3 Cases

Unusual clinical course, Unusual or unexpected effect of treatment

Connor M. Bunch A , Anthony V. Thomas B , John E. Stillson A , Laura Gillespie A , Kevin P. Lin D , Jacob Speybroeck A , Hau C. Kwaan D , Daniel H. Fulkerson D , Mahmud Zamlut B , Rashid Khan A , Mark M. Walsh A*

DOI: 10.12659/AJCR.931080

Am J Case Rep 2021; 22:e931080

Figure 1. Case 1: A 72-year-old woman with a past history of venous thromboembolism on chronic warfarin therapy presented with COVID-19 pneumonia. Three days after admission, she developed a pulmonary embolus despite an international normalized ratio of 6.4. (A) The patient’s initial thromboelastographic (TEG) tracing demonstrated hypocoagulopathy 1 day after developing the pulmonary embolus (dashed line). Two weeks later, her TEG tracing demonstrated hemostasis (dotted line). (B) Computed tomography angiogram of the chest in coronal view depicting branching filling defect along the distal right main pulmonary artery extending into the right upper lobe segmental branches (yellow arrow). (C) Right upper lobe pulmonary infarct was no longer present after repeat angiogram of the chest 2 weeks after its discovery.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923