Work

Spontaneous Sublingual Hematoma in a COVID‐19 Patient on Heparin Therapy: A Case Report and Review of Management Challenges

Year: 2025

Type: article

Abstract: COVID-19 is associated with a hypercoagulable state, often managed with anticoagulation therapy to prevent thrombotic events. However, anticoagulation can lead to rare but serious bleeding complications. We present the case of a 62-year-old male with severe COVID-19 admitted to the intensive care unit (ICU) with shortness of breath, cough, and oxygen desaturation. Also, he had diabetes, undergoing treatment with Neutral Protamine Hagedorn (NPH) insulin, and ischemic heart disease. On the eighth day of his admission, he developed a spontaneous sublingual hematoma while on unfractionated heparin therapy. The patient was managed conservatively with blood pressure control, cold compresses, adjustment of anticoagulation and close monitoring with laboratory anticoagulation tests, and careful observation. Despite the hematoma's initial enlargement, he exhibited no respiratory distress, and the hematoma gradually resolved without surgical intervention. This case highlights the need for vigilant monitoring, careful management of anticoagulation, and a multidisciplinary approach in balancing the benefits and risks of anticoagulation in COVID-19 patients.

Source: Case Reports in Medicine

DOI: 10.1155/carm/3371235

Authors: Mohsen Golkar, Anita Taheri, Milad Baseri, Parnian Nikraftar, Ramin Ansari, Ardeshir Khorsand

Institutions: Shahid Beheshti University, Shahid Beheshti University of Medical Sciences, Tehran University of Medical Sciences

Language: English

Topic: Case Reports on Hematomas

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $790