Spontaneous muscle bleeding in patients with COVID-19 (analysis of own observations)
I. V. Semeniakin,
O. V. Levchenko,
O. O. Yanushevich,
E. V. Grigor'eva,
I. V. Ivanova,
A. S. Sycheva,
A. A. Solodov,
D. A. Lezhnev,
A. L. Kebina https://doi.org/10.17238/2072-3180-2021-3-79-88
Abstract
Introduction. Purpose. Study the mechanisms of occurrence and the imaging characteristics of spontaneous intramuscular hemorrhage in patients with COVID-19 viral pneumonia.
Methods. The anamnesis, clinical and laboratory data and the results of computed tomography of 28 patients with spontaneous intramuscular hematomas associated with viral pneumonia were analyzed.
Results. According to computed tomography, 36 spontaneous hematomas of muscles and soft tissues of various localization were diagnosed (7 patients had multiple hematomas), mainly in women, the average age of the patient was 75 years. No arterial sources of bleeding were detected by contrast enhanced computed tomography. There was no correlation between the volume and timing of the development of hematomas with anticoagulant therapy. The appearance of 57.1% of hematomas after the 21st day from the onset of the disease was noted. In dynamics, the volume of hematomas didn’t increase and did not require surgical intervention.
Conclusion. Spontaneous intramuscular hemorrhage is a rare complication of COVID-19 viral pneumonia, leading to an unfavorable outcome only with a large volume of hematoma. Surgical treatment of hematomas is not required. The development of spontaneous hematomas can be influenced by both the prescribed anticoagulant therapy and the direct effect of the SARS-CoV-2 virus on the blood coagulation system and the endothelium of the wall of small vessels.
About the Authors
I. V. Semeniakin
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Semeniakin Igor Vladimirovich – PhD MD, Chief medical officer
of University Clinic
Kuskovskaya, 1A/1, 111398, Moscow
O. V. Levchenko
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
O. O. Yanushevich
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Yanushevich Oleg Olegovich – Academician RAS, PhD MD, Professor, Rector
Kuskovskaya, 1A/1, 111398, Moscow
E. V. Grigor'eva
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Grigor’eva Elena Vladimirovna – PhD MD, Chief of radiology
department of University Clinic
Kuskovskaya 1A/1, 111398, Moscow
I. V. Ivanova
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Ivanova Irina Vasilevna – PhD, radiologist, University Clinic of
Federal State Budgetary Educational Institution
Kuskovskaya 1A/1, 111398, Moscow
A. S. Sycheva
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Sycheva Alexandra Sergeevna – Chief of the 3rd therapy, Vice
Chief for Outpatient clinical work, University Clinic of Federal State Budgetary Educational Institution
Kuskovskaya, 1A/1, 111398, Moscow
A. A. Solodov
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Solodov Alexander Anatolyevich – PhD MD, Vice Chief for Anesthesiology and Resuscitation, University Clinic of Federal State Budgetary Educational Institution
Kuskovskaya, 1A/1, 111398, Moscow
D. A. Lezhnev
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Lezhnev Dmitrii Anatolyevich – PhD MD, Professor, Chief of
Department of Radiology Faculty of Dentistry, Federal State Budgetary Educational Institution
Vucheticha, 9A, 127206, Moscow
A. L. Kebina
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Kebina Anastasia Leonidovna - Deputy Chief Physician for medical Work, Federal State Budgetary Educational Institution
Kuskovskaya, 1A/1, 111398, Moscow
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Review
For citations:
Semeniakin I.V., Levchenko O.V., Yanushevich O.O., Grigor'eva E.V., Ivanova I.V., Sycheva A.S., Solodov A.A., Lezhnev D.A., Kebina A.L. Spontaneous muscle bleeding in patients with COVID-19 (analysis of own observations). Moscow Surgical Journal. 2021;(3):79-88. (In Russ.) https://doi.org/10.17238/2072-3180-2021-3-79-88
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