Author Information
An event is serious (based on the ICH definition) when the patient outcome is:
* death
* life-threatening
* hospitalisation
* disability
* congenital anomaly
* other medically important event
A 77-year-old woman1 developed chest wall haematoma during systemic anticoagulant therapy with enoxaparin sodium in COVID-19.
The woman, who had a history of diabetes, hypertension and obesity, was diagnosed with COVID-19 pneumonia. She started receiving remdesivir and off label therapy with hydroxychloroquine and tocilizumab for COVID-19 pneumonia. However, her oxygen requirement increased despite remdesivir treatment. Therefore, she was initiated on SC enoxaparin sodium [enoxaparin; dosage not stated]. After 5 days of enoxaparin sodium initiation, she reported upper left chest wall pain due to swelling with diffuse ecchymosis. She developed sudden hypotension, acute anaemia and lightheadedness. A CT angiography of the chest revealed arterial haematoma, which was attributed to enoxaparin sodium.
The woman underwent transfusion of several blood products and a 600mL chocolate-coloured fluid was drained using in-dwelling catheter. She required no surgical intervention or embolisation. Subsequently, her symptoms resolved, the catheter was withdrawn, and she was weaned to a nasal cannula with favourable outcome. She was discharged home without any adverse event.
Footnotes
Country of occurrence, reporter country and primary source country not stated. Abstract presented at the Chest. Conference: CHEST 2020 Annual Meeting, 2020-10-01.
Reference
- Mechineni A, et al. DILEMMA OF SYSTEMIC ANTICOAGULATION: A COVID-19 PATIENT WITH SPONTANEOUS CHEST WALL HEMATOMA. Chest 158 (Suppl.): A409, No. 4, Oct 2020. Available from: URL: 10.1016/j.chest.2020.08.400 [abstract] [DOI]