Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospital

SA Journal of Radiology

Field Value
Title Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospital
Creator Trentadue, Mirko Calligaro, Plinio Lazzarini, Gianluigi Bonomi Boseggia, Fabio Residori, Elena Hu, Jennifer Vanti, Silvana Lillo, Linda Varischi, Giovanna Cerini, Roberto
Subject Radiology; Emergency; Infectious diseases; Interventional radiology; COVID-19; bleeding; haemorrhage; haematoma; retroperitoneum
Description Background: Haemorrhages in coronavirus disease 2019 (COVID-19) patients require proper knowledge and management.Objectives: To highlight the characteristics of haemorrhages in patients with COVID-19 infection.Method: A retrospective study examined CT scans performed over a 13-month period in patients hospitalised with COVID-19 infection to determine those who developed spontaneous bleeding. The authors also investigated correlations between the bleeding events and the patients’ characteristics.Results: Haemorrhages occurred in 2.22% (31/1396) of patients hospitalised with COVID-19 infection (7.88%, 19/241 in the intensive care unit). Bleeding, major in most cases, occurred in anticoagulated patients, especially males with multiple comorbidities, aged between 60 and 79 years and mainly appeared in a single anatomical region (especially retroperitoneal), with the most voluminous in the chest wall. The complication was diagnosed on average 16.7 days after admission and occurred predominantly in critically ill patients undergoing invasive ventilation and pronation-supination cycles. In just under half of the cases, the haematomas were active, and in these cases, mainly with a single contrast blush and with earlier onset after the start of anticoagulation than in non-active bleeding. Major bleeding was also earlier in the presence of multiple morbidity. The vast majority of patients were treated conservatively and survived.Conclusion: At COVID-19 hospital centres, it is advisable that there is knowledge of such a complication for which CT imaging is essential for diagnosis and proper management. Although some authors have expressed doubts about anticoagulant treatment in patients with COVID-19, the bleeding complication in this study did not significantly affect the outcome.Contribution: Spontaneous haemorrhage did not significantly affect the outcome in this series.
Publisher AOSIS
Date 2022-10-31
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajr.v26i1.2509
Source South African Journal of Radiology; Vol 26, No 1 (2022); 9 pages 2078-6778 1027-202X
Language eng
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https://sajr.org.za/index.php/sajr/article/view/2509/3278 https://sajr.org.za/index.php/sajr/article/view/2509/3279 https://sajr.org.za/index.php/sajr/article/view/2509/3280 https://sajr.org.za/index.php/sajr/article/view/2509/3281
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Rights Copyright (c) 2022 Mirko Trentadue, Plinio Calligaro, Gianluigi Lazzarini, Fabio Bonomi Boseggia, Elena Residori, Jennifer Hu, Silvana Vanti, Linda Lillo, Giovanna Varischi, Roberto Cerini https://creativecommons.org/licenses/by/4.0