Table 2.
Summary of clinical characteristics, treatment and outcome of COVID-19 patients with retroperitoneal hematoma
| Case | Age/Sex | Comorbidity | Clinical presentation | Site of bleeding | Anticoagulation | Medical therapy | Intervention | Outcome |
|---|---|---|---|---|---|---|---|---|
| 1 [4] | 88/male | Vascular dementia, atrial flutter, ischaemic heart disease (IHD) | Right lower abdominal pain, palpable right iliac fossa mass | Rectus sheath hematoma | Therapeutic enoxaparin | Reversed with protamine sulfate | No | Alive |
| 2 [4] | 85/female | Not mentioned | Respiratory failure Incidental finding during computed tomography of the pulmonary angiogram (CTPA) | Left sided retroperitoneal hematoma | Not mentioned | Blood transfusion and reversal of anticoagulation | No | Not mentioned |
| 3 [4] | 66/male | Obstructive sleep apnoea, pulmonary hypertension, chronic obstructive pulmonary disease (COPD), atrial fibrillation (AF), obesity | Hypotension and anemia | Left sided retroperitoneal hematoma | Therapeutic enoxaparin | Volume resuscitation, blood transfusion and reversal of anticoagulation | No | Died |
| 4 [5] | 69/male | diabetes mellitus (DM), hypertension (HPT), IHD | Abdominal pain, hypovolemic shock (Day 20 admission) | Right psoas hematoma | Prophylactic enoxaparin (40 mg OD) Therapeutic enoxaparin (1 mg/kg) due to worsening hypoxemia with elevated d-dimers | Volume resuscitation, packed red blood cell (PRBC) and fresh frozen plasma (FFP) transfusion | Arterial embolization | Alive |
| 5 [6] | 77/male | HPT, dyslipidemia, AF (on apixaban) | Hemodynamic instability and anemia (D14 admission) | Left retroperitoneal hematoma | Prophylactic enoxaparin (100 UI/kg OD) | Volume resuscitation, blood transfusion, continuous renal replacement therapy (CRRT) | Surgical evacuation of hematoma | Alive |
| 6 [7] | 62/male | Not mentioned | Left lower back pain (D14 admission) | Left iliopsoas hematoma + retroperitoneal hematoma | Recombinant human soluble thrombomodulin (rhsTM; 12 800 U twice daily) X 5/7 Then Enoxaparin 40 mg OD | PRBC transfusion | Arterial embolization | Alive |
| 7 [7] | 79/male | Not mentioned | Right lower back pain Hypovolemic shock | Right iliopsoas hematoma + retroperitoneal hematoma | Intravenous UFH | PRBC transfusion | Arterial embolization | Died |
| 8 [8] | 65/male | DM, HPT | Right flank pain | Large retroperitoneal hematoma | IV Heparin 5000 u/6 H | Volume resuscitation | No | Alive |