Acute pulmonary embolism in COVID-19 related hypercoagulability

Cerruti, Lorenzo; Boscaro, Francesca; Francesco, Pignatelli; Campello, Elena; Spiezia, Luca; Simioni, Paolo

doi:10.1007/s11239-020-02160-1

Cited by 23 publications

(29 citation statements)

References 10 publications

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“…Several studies have reported the increased prevalence of thromboembolic events in COVID-19 infection. [8][9][10] The Figure 1 Initial anteroposterior (AP) chest radiograph depicting a large right-sided pneumothorax. Note the considerable leftward mediastinal shift.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported the increased prevalence of thromboembolic events in COVID-19 infection. 8–10 The systemic inflammation associated with COVID-19 and endothelial dysfunction, along with the generated hypercoagulable state, are the likely contributory factors to the pathogenesis of acute pulmonary emboli. The viscosity of blood is further increased by the hypoxia from severe pneumonia.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous tension pneumothorax and acute pulmonary emboli in a patient with COVID-19 infection

et al. 2020

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The COVID-19 pandemic has had a significant impact on the structure and operation of healthcare services worldwide. We highlight a case of a 64-year-old man who presented to the emergency department with acute dyspnoea on a background of a 2-week history of fever, dry cough and shortness of breath. On initial assessment the patient was hypoxic (arterial oxygen saturation (SaO2) of 86% on room air), requiring 10 L/min of oxygen to maintain 98% SaO2. Examination demonstrated left-sided tracheal deviation and absent breath sounds in the right lung field on auscultation. A chest radiograph revealed a large right-sided tension pneumothorax which was treated with needle thoracocentesis and a definitive chest drain. A CT pulmonary angiogram demonstrated segmental left lower lobe acute pulmonary emboli, significant generalised COVID-19 parenchymal features, surgical emphysema and an iatrogenic pneumatocoele. This case emphasises the importance of considering coexisting alternative diagnoses in patients who present with suspected COVID-19.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spontaneous tension pneumothorax and acute pulmonary emboli in a patient with COVID-19 infection

et al. 2020

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“…Геморрагическое пропитывание легочной ткани нередко является предвестником развивающегося острого респираторного дистресс-синдрома. Именно в развитии ге-моррагического отека ряд авторов видят причину исключительно быстрой отрицательной динамики изменений в легких при изначально небольшой площади поражения [21][22][23][24].…”

Section: рентгеноморфологические сопоставленияunclassified

“…2). Наиболее часто они относятся к криптогенной ОП, а также к ОП известной природы: при лекарственных поражениях, других, в т. ч. вирусных, инфекциях, радиационных повреждениях, системных заболеваниях соединительной ткани [24][25][26][27]. Типичными визуальными признаками являются многочисленные рассеянные (patchy) участки уплотнения легочной ткани по типу «матового стекла» в сочетании с консолидацией.…”

Section: рентгеноморфологические сопоставленияunclassified

“…ТЭЛА и тромбозы in situ связаны с развитием эндотелиального повреждения, синдрома системной воспалительной реакции и, как следствие, состояния гиперкоагуляции [24,56]. Подозрение на ТЭЛА является абсолютным показанием к проведению КТ-ангиографии.…”

Section: осложнения новой коронавирусной инфекции Covid-19unclassified

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Imaging of lung pathology in COVID-19 (literature review and own data)

Tyurin

Strutynskaya

2020

Pulʹmonologiâ (Mosk.)

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Novel coronavirus infection is predominantly manifests as lung tissue damage. Imaging methods, particularly, chest X-Ray and computed tomography, are of great importance for detecting pulmonary changes and differentiate them with other diseases (mainly other viral pneumonias). In the early disease stages the disease presents on CT with ground glass opacities, consolidations, crazy paving symptom. With time course, they can gradually decrease, evolve into organizing pneumonia or stay stable and even increase in volume with the spread of consolidation and formation of several signs of organizing pneumonia. Although radiological methods show high sensitivity in the detection of pulmonary changes, their specificity and prognostic ability are not so good today. Novel coronavirus infection can be complicated with pulmonary embolism, development thrombosis in situ in pulmonary small vessels, acute heart failure and subsequent development of cardiogenic pulmonary edema, bacterial superinfection, exacerbation or worsening of chronic lung disease and several iatrogenic issues (pneumothorax, pneumomediastinum, hematomas).

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Role of LL-37 in thrombotic complications in patients with COVID-19

Duan

Zhang

Chen

et al. 2022

Cell. Mol. Life Sci.

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Blood clot formation induced by dysfunctional coagulation is a frequent complication of coronavirus disease 2019 (COVID-19) and a high-risk factor for severe illness and death. Neutrophil extracellular traps (NETs) are implicated in COVID-19-induced immunothrombosis. Furthermore, human cathelicidin, a NET component, can perturb the interaction between the SARS-CoV-2 spike protein and its ACE2 receptor, which mediates viral entry into cells. At present, however, the levels of cathelicidin antimicrobial peptides after SARS-CoV-2 infection and their role in COVID-19 thrombosis formation remain unclear. In the current study, we analyzed coagulation function and found a decrease in thrombin time but an increase in fibrinogen level, prothrombin time, and activated partial thromboplastin time in COVID-19 patients. In addition, the cathelicidin antimicrobial peptide LL-37 was upregulated by the spike protein and significantly elevated in the plasma of patients. Furthermore, LL-37 levels were negatively correlated with thrombin time but positively correlated with fibrinogen level. In addition to platelet activation, cathelicidin peptides enhanced the activity of coagulation factors, such as factor Xa (FXa) and thrombin, which may induce hypercoagulation in diseases with high cathelicidin peptide levels. Injection of cathelicidin peptides promoted the formation of thrombosis, whereas deletion of cathelicidin inhibited thrombosis in vivo. These results suggest that cathelicidin antimicrobial peptide LL-37 is elevated during SARS-CoV-2 infection, which may induce hypercoagulation in COVID-19 patients by activating coagulation factors.

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Acute pulmonary embolism in COVID-19 related hypercoagulability

Cited by 23 publications

References 10 publications

Spontaneous tension pneumothorax and acute pulmonary emboli in a patient with COVID-19 infection

Spontaneous tension pneumothorax and acute pulmonary emboli in a patient with COVID-19 infection

Imaging of lung pathology in COVID-19 (literature review and own data)

Role of LL-37 in thrombotic complications in patients with COVID-19

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