Marchergustavsen8935
Coronavirus disease 2019 (COVID-19) may predispose patients to increased risk of venous thromboembolism (VTE) due to various pathophysiological mechanisms, including but not limited to endothelial injury, inflammation, cytokine-mediated microvascular damage, and reactive thrombocytosis. A high risk of vessel thrombosis correlates with disease severity, making early identification and treatment of prime consideration.Although identification of a deep venous thrombosis (DVT) or pulmonary embolism warrants immediate treatment with anticoagulation, trying to predict which COVID-19 patients may be at increased risk for developing these pathologies is challenging.
We present two cases of patients with COVID-19 who had ultrasonographic findings of turbulent blood flow within the deep venous system, without clear evidence of acute proximal DVT, who were subsequently found to have significant VTE.
Point-of-care lower extremity ultrasound has become one of the core applications used by emergency physicians. Typically we perform compression ultrasound for DVT evaluation. This novel finding of turbulent blood flow, or "smoke," within the deep venous system, may serve as a marker of increased risk of clot development and could be an indication to consider early anticoagulation.
Point-of-care lower extremity ultrasound has become one of the core applications used by emergency physicians. Typically we perform compression ultrasound for DVT evaluation. This novel finding of turbulent blood flow, or "smoke," within the deep venous system, may serve as a marker of increased risk of clot development and could be an indication to consider early anticoagulation.
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the etiology of the coronavirus disease 2019 (COVID-19) pandemic, has proven to be an era-defining illness with profound impact on patients and healthcare providers alike. By nearly all measures, daily cases and deaths are growing on a global scale despite conscious infection control efforts. As the medical community strives to better understand the pathogenesis of COVID-19, it has become increasingly appreciated that this "respiratory virus" can present clinically with a wide range of signs and symptoms not necessarily confined to the respiratory system.
Specifically, the central nervous system has been described as the presenting complaint of COVID-19, including anosmia and headaches and, more rarely, meningitis. This clinical case highlights the presentation of a 52-year-old male who presented to the emergency department with altered mental status and fever, ultimately attributed to COVID-19 infection.
This case serves to add to the growing body of evidence surrounding the potentially severe neuropathologic capabilities of the novel SARS-CoV-2 virus.
This case serves to add to the growing body of evidence surrounding the potentially severe neuropathologic capabilities of the novel SARS-CoV-2 virus.
While thrombotic complications of severe coronavirus disease 2019 (COVID-19) have been documented, the overall risk in non-critically ill cases of COVID-19 remains unknown.
We report a case of a previously healthy male patient who presented to the emergency department with headache and extremity paresthesia. The patient was diagnosed with cerebral venous thrombosis (CVT) and found to have a positive COVID-19 test. Inpatient anticoagulation was initiated, and symptoms had largely resolved at discharge.
This case demonstrates the importance of considering thrombotic complications, such as CVT, even in well-appearing COVID-19 patients with no other risk factors for thromboembolic disease.
This case demonstrates the importance of considering thrombotic complications, such as CVT, even in well-appearing COVID-19 patients with no other risk factors for thromboembolic disease.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for the coronavirus disease of 2019 (COVID-19) pandemic, has been associated with a variety of prothrombotic sequelae. The pathogenesis of this hypercoagulability has not yet been fully elucidated, but it is thought to be multifactorial with overactivation of the complement pathways playing a central role. There is emerging evidence that the resulting complications are not confined to the venous circulation, and even in patients without typical respiratory symptoms or traditional risk factors, there is a significant rate of arterial thromboembolic disease in patients with SARS-CoV-2 infection.
We describe a patient presenting with bilateral leg pain without any respiratory symptoms or fever who ultimately was found to be COVID-19 positive and had thromboembolism of the aorta and bilateral iliac occlusion. This report reviews available evidence on the prevalence of arterial thromboembolism in COVID-19 patients and some proposed mechanisms of the pathophysiology of COVID-19-associated coagulopathy.
It is important that the emergency physician maintain a high degree of suspicion for arterial thromboembolic disease in patients who are infected with COVID-19 even in the absence of typical respiratory symptoms. Additionally, COVID-19 should be considered in patients with unexplained thromboembolic disease, as this may increase the detection of COVID-19.
It is important that the emergency physician maintain a high degree of suspicion for arterial thromboembolic disease in patients who are infected with COVID-19 even in the absence of typical respiratory symptoms. Additionally, COVID-19 should be considered in patients with unexplained thromboembolic disease, as this may increase the detection of COVID-19.
Lung injury associated with the use of electronic cigarettes and vaping (EVALI) was first identified in 2019. MT-802 BTK inhibitor Since then, clusters of cases have been reported in the literature. Our aim was to describe the clinical presentation of adolescents with EVALI in the emergency department and their clinical outcomes.
In our case series, we identified seven adolescents diagnosed with EVALI. We describe their signs and symptoms on presentation to the emergency department and their clinical course. The most common symptoms on presentation were cough, shortness of breath, and vomiting. Each of these symptoms was seen in 71% of patients (n = 5), although not always together. Sinus tachycardia was noticed in 100% of patients (n = 7) and tachypnea in 85% (n = 6). While 85% (n = 6) required hospitalization for respiratory support, all patients were later discharged home on room air. After the diagnosis of EVALI, 85% of patients (n = 6) were treated with steroids.
EVALI is a new disease with unclear mechanisms that commonly presents with symptoms of cough, shortness of breath, and vomiting.
