Effectiveness of thrombolytic therapy in patients with severe COVID-19 and pulmonary embolism

Abstract

Current research provides insufficient data on the use of thrombolytic therapy in the treatment of pulmonary embolism in patients with COVID-19. Existing studies present data on the efficacy of thrombolytic drug therapy for thrombotic complications in severe COVID-19. However, these studies either involve a very small number of observations or remain incomplete. This article aimed to assess systemic thrombolysis’s effectiveness in intravenous alteplase administration in this pathology. The medical records of 92 patients were analysed. Patients were divided into four groups depending on the therapy administered. Patients in the first group had complications in the form of pulmonary embolism but did not require thrombolytic therapy. Treatment of patients in the first group consisted of prescribing low-molecular-weight heparin at a therapeutic dose. Patients in the second and third groups had pulmonary embolism in the context of COVID-19 and required thrombolytic therapy. The third group differed from the second in the presence of a thrombus in the right heart. Patients in the fourth group had complications in the form of pulmonary embolism, and required thrombolytic therapy, but did not receive it due to a lack of funds. Patients in the second and third groups were immediately treated with unfractionated heparin and alteplase. Thrombolysis was not performed in the fourth group. Mortality rates were studied according to the assigned group. It was established that the risk of death increased (p

Keywords

• thrombolysis
• acute respiratory distress syndrome
• alteplase
• unfractionated heparin