ผู้ป่วยโคโรน่าไวรัส-19 พบการเกิดลิ่มเลือดในหลอดเลือดดำร่วมกับลูปัส แอนตี้โคแอ็กกูแลนท์ (Lupus anticoagulant) และระดับของอดัมส์ 13 (ADAMTS-13) ต่ำ
Keywords:
COVID-19, Lupus Anticoagulant, ADAMTS-13Abstract
A Thai male, aged 58 years old presented respiratory symptoms, myalgia and acute fever. He had just
returned from an endemic area of COVID-19 infection outside Thailand. He was diagnosed with pneumonia from SARS-CoV-2 virus confirmed by nasal swab real time PCR and CT-scan of chest. He was treated with darunavia, ritonavia, favipiravir, azithromycin, chloroquine and intravenous immunoglobulin (IVIg). He also received antibiotics (levofloxacin, meropenem, vancomycin) and antifungal agent (micafungin). The pneumonia improved determined from chest X-ray and respirator setting. During treatment, the patient developed deep vein thrombosis of the right common iliac vein and was treated with unfractionated heparin infusion. The investigations of thrombophilia found positive lupus anticoagulant and low ADAMTS-13 level. The patient developed sudden cardiac arrest which EKG showed prolonged QT with acute anterolateral wall infarction. He passed away after cardiopulmonary resuscitation failed
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