Biomedicines · 5 authors, 4 centres
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This is a case report of a severely ill COVID-19 patient with portal vein thrombosis despite anticoagulation. The authors used point-of-care viscoelastic testing to guide and monitor a personalized systemic fibrinolytic therapy, which resolved the fibrinolysis shutdown and restored portal vein patency.
The report describes a single patient with severe COVID-19 who developed portal vein thrombosis and liver failure despite therapeutic anticoagulation and antiplatelet therapy. Viscoelastic testing (ClotPro) revealed profound fibrinolysis shutdown, with a clot lysis time (LT) of 755 seconds on the TPA-test. A targeted systemic fibrinolytic therapy with recombinant plasminogen activator (rtPA) was initiated. The case highlights that standard anticoagulation may be insufficient for COVID-19-associated coagulopathy and suggests that viscoelastic testing can guide personalized fibrinolytic therapy.
