avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2023-13-6-455-459avk-1695Research ArticleРАЗБОР КЛИНИЧЕСКИХ СЛУЧАЕВANALYSIS OF CLINICAL CASESИнфаркт селезенки и инфаркт миокарда у больного COVID-19 на антикоагулянтной терапии с нормальным уровнем D-димераSplenic Infarction and Myocardial Infarction in A Patient with COVID-19 on Anticoagulant Therapy with Normal D-Dimer Levelshttps://orcid.org/0000-0002-2543-6498ГрушаМ. И.GrushaM. I.

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Simferopol

https://orcid.org/0009-0000-0561-8895ХаметоваЮ. В.KhametovaY. V.

Юнна Владимировна Хаметова

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Yunna V. Khametova

Simferopol

tadanoyuurei@gmail.comhttps://orcid.org/0000-0001-6079-1527ФедорецА. В.FedoretsA. V.

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Simferopol

https://orcid.org/0009-0006-7509-7531СупруновВ. Э.SuprunovV. E.

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Simferopol

https://orcid.org/0009-0006-6219-1115МиналиеваА. С.MinalievaA. S.

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Simferopol

https://orcid.org/0009-0002-6149-3358СтахеевГ. К.StakheevG. K.

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Simferopol

Институт «Медицинская академия имени С.И. Георгиевского», ФГАОУ ВО «Крымский федеральный университет имени В.И. Вернадского», кафедра инфекционных болезнейРоссияV.I. Vernadsky Crimean Federal University, Institute “Medical Academy named after S.I. Georgievsky”, department of Infectious DiseasesRussian Federation202315012024136455458Copyright © Груша М.И., Хаметова Ю.В., Федорец А.В., Супрунов В.Э., Миналиева А.С., Стахеев Г.К., 20242024Груша М.И., Хаметова Ю.В., Федорец А.В., Супрунов В.Э., Миналиева А.С., Стахеев Г.К.Grusha M.I., Khametova Y.V., Fedorets A.V., Suprunov V.E., Minalieva A.S., Stakheev G.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1695

Многие исследования показали, что COVID-19 может прогрессировать с коагулопатией и мультисистемными тромботическими патологиями. В данной статье представлен случай пациента, у которого через 9 дней после лабораторно подтвержденной коронавирусной пневмонии на фоне антикоагулянтной терапии был, при повторной госпитализации, диагностирован инфаркт селезенки в сочетании с последующим острым инфарктом миокарда. Предупреждение тромбоза профилактическими дозами низкомолекулярного гепарина у госпитализированных пациентов с COVID-19 может оказаться недостаточным для предотвращения развития коагулопатии. Следует заподозрить у COVID-19-положительного пациента с болью в животе абдоминально-висцеральную тромбоэмболию, несмотря на антикоагулянтную терапию и нормальный уровень D-димера.

Many studies have shown that COVID-19 can progress with coagulopathy and multisystem thrombotic pathologies. This article presents the case of a patient who, 9 days after laboratory-confirmed coronavirus pneumonia against the background of anticoagulant therapy, was diagnosed with splenic infarction in combination with acute myocardial infarction during subsequent hospitalization. Prevention of thrombosis with prophylactic doses of low molecular weight heparin in hospitalized patients with COVID-19 may not be sufficient to prevent the development of coagulopathy. Abdominal visceral thromboembolism should be suspected in a COVID-19 positive patient with abdominal pain despite anticoagulant therapy and normal D-dimer levels.

инфаркт селезенкиCOVID-19острый инфаркт миокардакоагулопатиятромбозsplenic infarctionCOVID-19acute myocardial infarctioncoagulopathythrombosisReferencesde Roquetaillade C., Chousterman B.G., Tomasoni D., et al. Unusual arterial thrombotic events in Covid-19 patients. International Journal of Cardiology. 2021; 323: 281-284. doi: 10.1016/j.ijcard.2020.08.103de Roquetaillade C., Chousterman B.G., Tomasoni D., et al. Unusual arterial thrombotic events in Covid-19 patients. International Journal of Cardiology. 2021; 323: 281-284. doi: 10.1016/j.ijcard.2020.08.103Santos Leite Pessoa M., Franco Costa Lima C., Farias Pimentel A.C., et al. Multisystemic Infarctions in COVID-19: Focus on the Spleen. European journal of case reports in internal medicine. 2020;7(7):001747. doi: 10.12890/2020_001747Santos Leite Pessoa M., Franco Costa Lima C., Farias Pimentel A.C., et al. Multisystemic Infarctions in COVID-19: Focus on the Spleen. European journal of case reports in internal medicine. 2020;7(7):001747. doi: 10.12890/2020_001747Ramanathan M., Chueng T., Fernandez E., et al. Concomitant renal and splenic infarction as a complication of COVID-19: a case report and literature review. Le infezioni in Medicina. 2020; 28(4): 611-615.Ramanathan M., Chueng T., Fernandez E., et al. Concomitant renal and splenic infarction as a complication of COVID-19: a case report and literature review. Le infezioni in Medicina. 2020; 28(4): 611-615.Karki S., Rawal S.B., Malla S., et al. A case report on spontaneous hemoperitoneum in COVID-19 patient. International Journal of Surgery Case Reports. 2020; 75: 211-213. doi:10.1016/j.ijscr.2020.09.078Karki S., Rawal S.B., Malla S., et al. A case report on spontaneous hemoperitoneum in COVID-19 patient. International Journal of Surgery Case Reports. 2020; 75: 211-213. doi:10.1016/j.ijscr.2020.09.078Castro G.R.A., Collaço I.A., Dal Bosco C.L.B., et al. Splenic infarction as a complication of covid-19 in a patient without respiratory symptoms: A case report and literature review. IDCases. 2021; 24: e01062. doi: 10.1016/j.idcr.2021.e01062Castro G.R.A., Collaço I.A., Dal Bosco C.L.B., et al. Splenic infarction as a complication of covid-19 in a patient without respiratory symptoms: A case report and literature review. IDCases. 2021; 24: e01062. doi: 10.1016/j.idcr.2021.e01062Porfidia A., Pola R. Venous thromboembolism in COVID-19 patients. Journal of thrombosis and haemostasis. 2020; 18(6): 1516-1517. doi: 10.1111/jth.14842Porfidia A., Pola R. Venous thromboembolism in COVID-19 patients. Journal of thrombosis and haemostasis. 2020; 18(6): 1516-1517. doi: 10.1111/jth.14842Voicu S., Bonnin P., Stépanian A., et al. High Prevalence of Deep Vein Thrombosis in Mechanically Ventilated COVID-19 Patients. Journal of the American College of Cardiology. 2020; 76(4): 480-482. doi: 10.1016/j.jacc.2020.05.053Voicu S., Bonnin P., Stépanian A., et al. High Prevalence of Deep Vein Thrombosis in Mechanically Ventilated COVID-19 Patients. Journal of the American College of Cardiology. 2020; 76(4): 480-482. doi: 10.1016/j.jacc.2020.05.053Nepogodiev D., Bhangu A., Glasbey J.C., et al. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020; 396(10243): 27-38. doi: 10.1016/S0140-6736(20)31182-XNepogodiev D., Bhangu A., Glasbey J.C., et al. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020; 396(10243): 27-38. doi: 10.1016/S0140-6736(20)31182-XRanucci M., Ballotta A., Di Dedda U., et al. The procoagulant pattern of patients with COVID-19 acute respiratory distress syndrome. Journal of thrombosis and haemostasis. 2020; 18(7): 1747-1751. doi:10.1111/jth.14854Ranucci M., Ballotta A., Di Dedda U., et al. The procoagulant pattern of patients with COVID-19 acute respiratory distress syndrome. Journal of thrombosis and haemostasis. 2020; 18(7): 1747-1751. doi:10.1111/jth.14854

The authors declare that there are no conflicts of interest present.