Anticoagulation in the obese patient with COVID-19-associated venous thromboembolism.

Autor:	McCormick JP; Internal Medicine, Midland Regional Hospital Portlaoise, Portlaoise, Ireland john.mc-cormick@ucdconnect.ie., Connaughton J; Internal Medicine, Midland Regional Hospital Portlaoise, Portlaoise, Ireland., McDonnell N; Internal Medicine, Midland Regional Hospital Portlaoise, Portlaoise, Ireland.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2021 Jun 11; Vol. 14 (6). Date of Electronic Publication: 2021 Jun 11.
DOI:	10.1136/bcr-2021-242675
Abstrakt:	A 61-year-old obese man who had recently tested positive for COVID-19 presented to the emergency department following an unwitnessed collapse, with a brief period of unresponsiveness. CT pulmonary angiography confirmed the presence of extensive bilateral pulmonary embolism despite the patient reporting full compliance with long-term dabigatran. The patient was initially anticoagulated with low-molecular-weight heparin and was treated with non-invasive ventilation and dexamethasone for COVID-19 pneumonia. He made a full recovery and was discharged on oral rivaroxaban. His case highlighted some of the common problems encountered when selecting an anticoagulation strategy for obese patients, as well as the lack of definitive evidence to guide treatment decisions. These challenges were further complicated by our incomplete understanding of the underlying mechanisms of COVID-19 coagulopathy, with limited data available regarding the optimal management of thromboembolic complications. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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