Article ; Online: Unexpected acute pulmonary embolism in an old COVID-19 patient with warfarin overdose: a case report.
European heart journal. Case reports
2021 Volume 5, Issue 6, Page(s) ytab206
Abstract: ... Pulmonary embolism should still be considered in COVID-19 patients even with effective or overdosed anticoagulant ... here the case of an 89-year-old patient receiving warfarin for atrial fibrillation and ... valvular heart disease, admitted to the intensive care unit for respiratory failure due to COVID-19. The patient ...
| Abstract | Background: Severe acute respiratory syndrome coronavirus 2 disease is strongly associated with a high incidence of thrombotic events. Anticoagulation could be a cornerstone in successfully managing severe forms of coronavirus disease 2019 (COVID-19). However, optimal anticoagulant dosing in elderly patients is challenging because of high risk of both thrombosis and bleeding. Case summary: We present here the case of an 89-year-old patient receiving warfarin for atrial fibrillation and valvular heart disease, admitted to the intensive care unit for respiratory failure due to COVID-19. The patient presented with a severe epistaxis associated with warfarin overdose [international normalized ratio (INR) > 10]. After a successful initial reversal using vitamin K Discussion: This case report illustrates the complexity of COVID-19 pathophysiology and its management for physicians, especially in patients receiving vitamin K antagonists (VKAs). Infection, concurrent medication use, and pharmacogenetic factors involved in VKA metabolism and pharmacodynamics may lead to a loss of control of anticoagulation. Pulmonary embolism should still be considered in COVID-19 patients even with effective or overdosed anticoagulant therapy. |
|---|---|
| Language | English |
| Publishing date | 2021-06-05 |
| Publishing country | England |
| Document type | Case Reports |
| ISSN | 2514-2119 |
| ISSN (online) | 2514-2119 |
| DOI | 10.1093/ehjcr/ytab206 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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