About: Thrombolysis in severe COVID-19 pneumonia with massive pulmonary embolism

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An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Thrombolysis in severe COVID-19 pneumonia with massive pulmonary embolism
Creator	Memish, Ziad Karakitsos, Dimitrios Alharthy, Abdulrahman Balhamar, Abdullah Faqihi, Fahad Papanikolaou, John Blaivas, Mike
source	Elsevier; Medline; PMC
abstract	OBJECTIVE: No guidelines exist for the management of massive pulmonary embolism (PE) in COVID-19. We present a COVID-19 patient with refractory acute respiratory syndrome (ARDS), and life-threatening PE who underwent successful thrombolysis. CASE PRESENTATION: A previously healthy 47 year old male was admitted to our hospital due to severe COVID-19 pneumonia [confirmed by Real-Time-Polymerase-Chain-Reaction (RT-PCR)]. He had rapidly evolving ARDS [partial arterial pressure of oxygen to fractional inspired concentration of oxygen ratio: 175], and sepsis. Laboratory results showed lymphocytopenia, and increased D-dimer levels (7.7 μg/ml; normal: 0–0.5 μg/ml). The patient was treated in the intensive care unit. On day-1, ARDS-net/prone positioning ventilation, and empiric anti-COVID treatment integrating prophylactic anticoagulation was administered. On hospital day-2, the patient developed shock with worsening oxygenation. Point-of-care-ultrasound depicted a large thrombus migrating from the right atrium to the pulmonary circulation. Intravenous alteplase (100 mg over 2 h) was administered as rescue therapy. The patient made an uneventful recovery, and was discharged to home isolation (day-20) on oral rivaroxaban. CONCLUSION: Thrombolysis may have a critical therapeutic role for massive PE in COVID-19; however the risk of potential bleeding should not be underestimated. Point-of-care ultrasound has a pivotal role in the management of refractory ARDS in COVID-19.
has issue date	2020-07-30(xsd:dateTime)
bibo:doi	10.1016/j.ajem.2020.07.068
bibo:pmid	32763101
has license	no-cc
sha1sum (hex)	705ffc05894a88cde88368dfe6833d4918cdb031
schema:url	https://doi.org/10.1016/j.ajem.2020.07.068
resource representing a document's title	Thrombolysis in severe COVID-19 pneumonia with massive pulmonary embolism
has PubMed Central identifier	PMC7392155
has PubMed identifier	32763101
schema:publication	Am J Emerg Med
resource representing a document's body	covid:705ffc05894a88cde88368dfe6833d4918cdb031#body_text
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