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Spontaneous pulmonary hematoma in patients with COVID-19. RADIOLOGIA 2023; 65:176-179. [PMID: 37059582 PMCID: PMC10020037 DOI: 10.1016/j.rxeng.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/29/2021] [Indexed: 03/19/2023]
Abstract
The disease caused by Sars-Cov-2 (Covid-19) has become a worldwide pandemic and consequently a public health problem. Multiple complications associated with Covid-19 have been described, including coagulation abnormalities. Although the infection is known to induce a prothrombotic state, hemorrhagic complications have also been reported in patients with Covid-19, especially in anticoagulated patients. We present two cases of spontaneous pulmonary hematoma in patients with Covid-19 undergoing anticoagulant treatment. We aim to describe this complication, which although uncommon, should be taken into account in anticoagulated patients with Covid-19.
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Lozano C, González A, Andreu M, Castañer E. [Spontaneous pulmonary hematoma in patients with COVID-19]. RADIOLOGIA 2023; 65:176-179. [PMID: 35370312 PMCID: PMC8610840 DOI: 10.1016/j.rx.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/29/2021] [Indexed: 11/26/2022]
Abstract
The disease caused by Sars-Cov-2 (Covid-19) has become a worldwide pandemic and consequently a public health problem. Multiple complications associated with Covid-19 have been described, including coagulation abnormalities. Although the infection is known to induce a prothrombotic state, hemorrhagic complications have also been reported in patients with Covid-19, especially in anticoagulated patients. We present two cases of spontaneous pulmonary hematoma in patients with Covid-19 undergoing anticoagulant treatment. We aim to describe this complication, which although uncommon, should be taken into account in anticoagulated patients with Covid-19.
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Affiliation(s)
- C Lozano
- UDIAT-Centro Diagnóstico, Servicio de Diagnóstico por la Imagen, Parc Taulí Hospital Universitario, Instituto de Investigación e Innovación Parc Taulí (I3PT), Sabadell, Barcelona, España
| | - A González
- UDIAT-Centro Diagnóstico, Servicio de Diagnóstico por la Imagen, Parc Taulí Hospital Universitario, Instituto de Investigación e Innovación Parc Taulí (I3PT), Sabadell, Barcelona, España
| | - M Andreu
- UDIAT-Centro Diagnóstico, Servicio de Diagnóstico por la Imagen, Parc Taulí Hospital Universitario, Instituto de Investigación e Innovación Parc Taulí (I3PT), Sabadell, Barcelona, España
| | - E Castañer
- UDIAT-Centro Diagnóstico, Servicio de Diagnóstico por la Imagen, Parc Taulí Hospital Universitario, Instituto de Investigación e Innovación Parc Taulí (I3PT), Sabadell, Barcelona, España
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Petreanu CA, Vlăsceanu S, Zaharia D, Jipa D, Moldovan H, Gheorghiță D, Iliuță L, Rădulescu B, Bădărău IA, Savu CF. Spontaneous Pulmonary Hematoma: Case Report of a Giant Post-COVID-19 Hematoma and Literature Review. Healthcare (Basel) 2023; 11:healthcare11040527. [PMID: 36833061 PMCID: PMC9957326 DOI: 10.3390/healthcare11040527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 02/12/2023] Open
Abstract
Pulmonary hematomas are a rare pathology. Although they are usually reported post-traumatically, there are also spontaneous forms in pulmonary pathologies or during drug therapy. In these spontaneous entities, primitive forms are rarely described, although the contributory local pulmonary pathological terrain or a specific associated medication has not yet been identified. We present the case of a patient who developed a giant pulmonary hematoma that appeared spontaneously during recovery from COVID-19 infection. It appeared in one of the two bullae-like cystic lung lesions developed during secondary COVID-19 infection. The clinical impact was major, with hypotension and anemia being observed, requiring hemodynamic support and the adjustment of drug therapy. The clinical course was favorable, with a quasi-complete resolution of both the hematoma and a second cystic lesion being observable at 8 months by pulmonary remodeling. Spontaneous pulmonary hematomas may constitute a pathological entity associated with a post-COVID-19 remodeling process of the lung and the related anticoagulant treatment, which should be recognized, especially in the actual COVID-19 pandemic or in the widespread use of anticoagulant treatment. Conservative treatment is the method of choice, even in giant lung forms.
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Affiliation(s)
- Cornel Adrian Petreanu
- Department of Thoracic Surgery, “Marius Nasta” National Institute of Pneumology, 050152 Bucharest, Romania
- Thoracic Surgery Clinic I, “Carol Davila” University of Medicine and Pharmacy, 030167 Bucharest, Romania
| | - Silviu Vlăsceanu
- Department of Thoracic Surgery, “Marius Nasta” National Institute of Pneumology, 050152 Bucharest, Romania
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 030167 Bucharest, Romania
- Correspondence: (S.V.); (H.M.)
| | - Dragoș Zaharia
- Department of Pneumology, “Marius Nasta” National Institute of Pneumology, 050152 Bucharest, Romania
- Pneumology Clinic, “Carol Davila” University of Medicine and Pharmacy, 030167 Bucharest, Romania
| | - Daniela Jipa
- Department of Pneumology, “Marius Nasta” National Institute of Pneumology, 050152 Bucharest, Romania
- Pneumology Clinic, “Carol Davila” University of Medicine and Pharmacy, 030167 Bucharest, Romania
| | - Horațiu Moldovan
- Department of Cardiovascular Surgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Cardiovascular Surgery, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania
- Academy of Romanian Scientists, 050045 Bucharest, Romania
- Correspondence: (S.V.); (H.M.)
| | - Daniela Gheorghiță
- Faculty of Materials Science and Engineering, Politehnica University of Bucharest, 060042 Bucharest, Romania
| | - Luminița Iliuță
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Bogdan Rădulescu
- Department of Cardiovascular Surgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Cardiovascular Surgery, Prof. Dr. C.C. Iliescu Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania
| | - Ioana Anca Bădărău
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 030167 Bucharest, Romania
| | - Cornel Florentin Savu
- Department of Thoracic Surgery, “Marius Nasta” National Institute of Pneumology, 050152 Bucharest, Romania
- Thoracic Surgery Clinic I, “Carol Davila” University of Medicine and Pharmacy, 030167 Bucharest, Romania
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Brogna B, Romano A, Tibullo L, Montuori M, Nunziata M, Russo G, Musto LA. Rare findings of spontaneous hemothorax and small subpleural lung hematoma in a COVID-19 patient: A case report. Acta Radiol Open 2021; 10:20584601211028149. [PMID: 34367668 PMCID: PMC8326360 DOI: 10.1177/20584601211028149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/07/2021] [Indexed: 01/27/2023] Open
Abstract
Hemothorax (HT) and pulmonary hematoma represent rare complications of anticoagulant therapy. We present a rare case of a 53-year-old man with COVID-19 pneumonia who showed, in a follow-up computed tomography (CT) scan 13 days after hospitalization, a left HT and a small hyperdense area in a subpleural location and compatible with a small subpleural hematoma. This patient was being treated with a subcutaneous administration of low-molecular-weight heparin (100UI/kg/BID). No vascular malformations were visualized on the CT pulmonary angiography. Herein, we report the first case of both a spontaneous HT and a lung subpleural hematoma in a COVID-19 patient, probably caused by anticoagulant therapy.
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Affiliation(s)
- Barbara Brogna
- Department of Radiology, San Giuseppe Moscati Hospital Avellino, Avellino, Italy
- Barbara Brogna, Department of Radiology San Giuseppe Moscati Hospital Avellino, National Speciality Hospital San Giuseppe Moscati Neurology and Stroke Unit, Contrada Amoretta, Avellino 83100, Italy.
| | - Annamaria Romano
- Department of Pneumology, San Giuseppe Moscati Hospital Avellino, Avellino, Italy
| | - Loredana Tibullo
- Department of General Medicine, San Giuseppe Moscati Hospital Avellino, Avellino, Italy
| | - Mariagrazia Montuori
- Department of Pneumology, San Giuseppe Moscati Hospital Avellino, Avellino, Italy
| | - Mariagrazia Nunziata
- Department of General Medicine, San Giuseppe Moscati Hospital Avellino, Avellino, Italy
| | - Giuseppe Russo
- Department of Pneumology, San Giuseppe Moscati Hospital Avellino, Avellino, Italy
| | - Lanfranco A Musto
- Department of Radiology, San Giuseppe Moscati Hospital Avellino, Avellino, Italy
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