Spontaneous muscle hematoma in older patients with COVID-19: two case reports and literature review

Rogani, Sara; Calsolaro, Valeria; Franchi, Riccardo; Calabrese, Alessia Maria; Okoye, Chukwuma; Monzani, Fabio

doi:10.1186/s12877-020-01963-4

Cited by 34 publications

(27 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The arteries most commonly involved are the femoral artery, epigastric artery, and superior thoracic artery. A causal and temporal relationship has been found with SARS-CoV-2 infection; hence it is crucial to look out for this bleeding complication in COVID-19 patients on heparin or with trauma [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Major Bleeding Complications in COVID-19 Patients

Boira¹,

Esteban²,

Vañes³

et al. 2021

Cureus

View full text Add to dashboard Cite

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with thrombotic phenomena in the early stages of the disease, but also, less frequently, with major bleeding between the second and third week after onset, particularly in patients treated with therapeutic anticoagulation. This article describes four cases of patients admitted to the hospital with severe SARS-CoV-2 pneumonia who had arterial bleeding as a complication while on low-molecular-weight heparin at therapeutic doses. Half of the patients were women.

show abstract

Section: Discussionmentioning

confidence: 99%

Major Bleeding Complications in COVID-19 Patients

Boira¹,

Esteban²,

Vañes³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…Another study described two patients under LMWH treatment for atrial fibrillation. These COVID-19 positive cases had spontaneous muscle hematoma [ 13 ]. Retroperitoneal hemorrhage also happened in a SARS-CoV-2 patient on daily use of aspirin for coronary artery disease and enoxaparin due to COVID-19-induced hypercoagulable state [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Parenteral Anticoagulation and Retroperitoneal Hemorrhage in COVID-19: Case Report of Five Patients

Mahboubi-Fooladi

Arabi

Khazaei

et al. 2021

SN Compr. Clin. Med.

View full text Add to dashboard Cite

Since coronavirus disease 2019 (COVID-19) is associated with a hypercoagulable state, especially in critical patients, anticoagulation is used for thromboprophylaxis. Hemorrhagic complications, even uncommon ones such as retroperitoneal hemorrhage, can occur following anticoagulant administration. We present 5 patients with COVID-19 whose clinical course was complicated by spontaneous retroperitoneal hemorrhage. The patients were initially presented with respiratory manifestations of the infection. There was no history or evidence suggestive for traumatic injury. After hospitalization, the patients received supplemental oxygen, antibiotics, enoxaparin or heparin, interferon beta-1b (in three patients), and anticoagulation with subcutaneous injection of enoxaparin (three patients) or heparin (two patients). During the course of hospitalization, the patients showed sudden-onset abdominal pain (three cases), hypotension (three cases), and an acute drop in hemoglobin level. CT scan of the abdomen and pelvis revealed retroperitoneal hemorrhage. For one patient, owing to unstable vital signs and an expanding hematoma, surgical intervention was performed. Others were managed conservatively with discontinuation of anticoagulants, intravenous (IV) fluid resuscitation, and packed red blood cells transfusion. Three patients died due to worsening of the infection and respiratory failure. Retroperitoneal hemorrhage could be a potential complication in COVID-19 patients receiving anticoagulation. Careful monitoring of the vital signs and blood tests like hemoglobin level of such patients is essential.

show abstract

“…17 Types of bleeding may include gastrointestinal bleeding, hemoptysis, oral mucosa bleeding, bleeding from multiple cannulation sites, intracranial hemorrhage, internal bleeding, pulmonary and renal hemorrhages. 17 Spontaneous muscle hematoma (SMH) is a rare complication in COVID-19 patients 18 and its clinical characteristics have not yet been fully described.…”

mentioning

confidence: 99%

Spontaneous Muscle Hematoma in Patients with COVID-19: A Systematic Literature Review with Description of an Additional Case Series

Abate

Casoria

Rendina

et al. 2021

Semin Thromb Hemost

View full text Add to dashboard Cite

Coagulation abnormalities, thrombosis, and endothelial dysfunction have been described in COVID-19 patients. Spontaneous muscle hematoma (SMH) is a rare complication in COVID-19. The aims of this study are to: (1) perform a systematic review of the literature to better define the clinical SMH characteristics, (2) describe the prevalence and the clinical characteristics of SMH in COVID-19 patients referring to a Department of Internal Medicine (IM) (Federico II University of Naples), a Department of Sub-Intensive Care Medicine (SIM) (Ospedale Del Mare), and a Department of Intensive Care Unit (ICU) (Federico II University). The systematic review was performed according to PRISMA criteria. The local prevalence of SMH in COVID-19 was evaluated retrospectively. The medical records of all COVID-19 patients referring to IM and ICU from March 11th, 2020, to February 28th, 2021 were examined for SMH occurrence. In our retrospective analysis, we describe 10 cases of COVID-19 patients with SMH not previously reported in literature, with a prevalence of 2.1%. The literature review, inclusive of our case series, describes a total of 50 SMHs in COVID-19 patients (57.4% males; mean age 68.8 ± 10.0 years). The SMH sites were ileo-psoas, vastus intermedius, gluteus, sternocleidomastoid, and pectoralis major muscles. Males developed SMH earlier than females (9.5 ± 7.8 vs. 17.1 ± 9.7 days). Ileo-psoas hematoma was more frequent in males (69.2 vs. 30.8%), while pectoralis major hematoma occurred only in females. The in-hospital mortality rate of SMH in COVID-19 patients was 32.4%. SMH is a rare but severe complication in COVID-19 hospitalized patients, associated with high mortality. A gender difference seems to be present in the clinical presentation of the disorder.

show abstract

Spontaneous muscle hematoma in older patients with COVID-19: two case reports and literature review

Cited by 34 publications

References 18 publications

Major Bleeding Complications in COVID-19 Patients

Major Bleeding Complications in COVID-19 Patients

Parenteral Anticoagulation and Retroperitoneal Hemorrhage in COVID-19: Case Report of Five Patients

Spontaneous Muscle Hematoma in Patients with COVID-19: A Systematic Literature Review with Description of an Additional Case Series

Contact Info

Product

Resources

About