Successful systemic fibrinolysis in a patient with Covid- 19: Case report
| Autor: | María Gomez Rojo, Laura Betolaza Weimer, Begoña Ortolá Rocher, Guillermo Bartolomé Rubio, Paloma Repáraz Grávalos, Diego Gil Mayo, Beatriz Flores Cajal, María León Núñez |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Gynecology
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) business.industry Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) medicine.medical_treatment Context (language use) Acute respiratory distress 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine medicine.disease Sindrome de 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine Fibrinolysis medicine 030212 general & internal medicine Thrombus business Hemodynamic instability |
| Zdroj: | Colombian Journal of Anesthesiology. 49 |
| ISSN: | 2256-2087 2422-0248 |
| DOI: | 10.5554/22562087.e969 |
| Popis: | The new coronavirus 2019-nCov or SARS-Cov-2 is responsible for the most important pandemic in the 21st century: the coronavirus disease (COVID-19). The 2019-nCov infection elicits a hyper-coagulable state, conditioning a worse outcome in these patients. The pathophysiology of the exaggerated coagulation activation in these patients is still unknown, and probably involves several mechanisms, different from those involved in sepsis-associated coagulopathy. This article discusses the case of a patient with no remarkable medical history, who after 7 days of fever, diarrhea and epigastric pain was diagnosed with COVID-19 bilateral pneumonia, further aggravated by severe Acute Respiratory Distress Syndrome. In this context, the patient experienced a massive acute pulmonary t hromboembolism accompanied by an acute thrombus in the heart's right ventricle, leading to hemodynamic instability. For the first time in our center in these patients, systemic fibrinolysis was successfully performed, with resolution of the intracavitary thrombus and the acute hemodynamic shock. (English) [ABSTRACT FROM AUTHOR] El nuevo coronavirus 2019-nCov o SARS-Cov-2 es responsable de la pandemia mas importante del siglo xxI: la enfermedad del coronavirus (COVID-19). La infeccion por 2019-nCov produce un estado de hipercoagulabilidad, que promueve peores desenlaces en estos pacientes. La fisiopa-tologia de la exagerada activacion de la coagulacion en estos pacientes aun se desconoce y posiblemente involucre varios mecanismos, diferentes a los participan en la coagulopatia asociada a sepsis. El presente articulo presenta el caso de un paciente sin antecedentes medicos y quien luego de 7 dias de fiebre, diarrea y dolor epigastrico, fue diagnosticado con neumonia bilateral por COVID-19, agravada por la presencia de Sindrome de Dificultad Respiratoria Aguda. En este contexto, el paciente desarrolla un tromboembolismo pulmonar agudo masivo, acompanado de un trombo agudo en el ventriculo derecho, produciendole inestabilidad hemodinamica. Por primera vez en nuestro centro, se realizo exitosamente una fibrinolisis sistemica, con resolucion del trombo intracavitario y del shock hemodinamico agudo. (Spanish) [ABSTRACT FROM AUTHOR] Copyright of Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiologia is the property of Sociedad Colombiana de Anestesiologia y Reanimacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Databáze: | OpenAIRE |
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