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Pulmonary embolism in coronavirus disease 2019: the silent killer.

Authors
  • Marwah, Vikas1
  • Peter, Deepu K2
  • Malik, Virender3
  • Mishra, Satish Chandra4
  • Kumar, Tentu Ajai5
  • Kumar, Arvind6
  • Bhati, Gaurav7
  • Kumar, Nikhil8
  • Singh, Shalendra9
  • Choudhary, Robin8
  • 1 Professor & Head (Pulmonary, Critical Care & Sleep Medicine), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India. , (India)
  • 2 Graded Specialist (Pulmonary, Critical Care & Sleep Medicine), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India. , (India)
  • 3 Associate Professor (Radiology), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India. , (India)
  • 4 Consultant & Head (Cardiology), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India. , (India)
  • 5 Associate Professor (Pulmonary, Critical Care & Sleep Medicine), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India. , (India)
  • 6 Resident (Paediatric Pulmonology & Intensive Care), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India. , (India)
  • 7 Assistant Professor (Pulmonary, Critical Care & Sleep Medicine), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India. , (India)
  • 8 Resident (Pulmonary, Critical Care & Sleep Medicine), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India. , (India)
  • 9 Assistant Professor & Neuroanaesthesiologist, Department of Anaesthesia, Armed Forces Medical College, Pune, India. , (India)
Type
Published Article
Journal
Medical Journal Armed Forces India
Publisher
Elsevier
Publication Date
Jul 01, 2021
Volume
77
Identifiers
DOI: 10.1016/j.mjafi.2021.03.025
PMID: 34334899
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Pulmonary embolism (PE) has been identified as one of the deadliest complications of coronavirus disease 2019 (COVID-19), especially in patients admitted to the intensive care unit (ICU). Western literature reminds us of the high prevalence of PE in COVID. Here, we report a series of 13 cases of PE diagnosed and managed at our hospital. Retrospective analysis of medical records of 13 cases of PE admitted at our hospital from February 1, 2020, to September 31, 2020, were done. Their clinical, laboratory, and radiologic data were assessed in detail. Computed tomography pulmonary arteriography was used to make the diagnosis in eight patients (61.53%), and clinical findings with corroborative ultrasound and laboratory parameters were used to label PE in five patients (38.46%). Five patients were hemodynamically unstable, requiring thrombolysis with recombinant tissue plasminogen activator, and four patients (30.76%) suffered a fatal outcome. COVID-19 is a highly prothrombotic state, and all physicians should keep a high vigilance for PE. All hospitalized patients with COVID-19, especially those admitted in ICU, should be on prophylactic anticoagulation and, if there is any worsening, should be started on therapeutic regimen. Patients at the time of discharge should be switched to oral anticoagulation, which should be continued for at least 3-6 months. © 2021 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd.

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