Can pulmonary embolism still happen despite anticoagulant therapy in post covid complication?

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Absolutely sir. That too very difficult to diagnose. My personal opinion is also same sir. Even after giving optimum anticoagulation therapy, thromboembolism occurs in covid pneumonia cases. May be TNK TpA helpful in strong Suspicious cases with explained risk of bleeding.

SARS Cov 2 virus enters cells through ACE 2 receptors. Vascular endothelium has ACE 2 receptors. SARS Cov 2 virus enters into the vascular endothelium and cause extensive damage to endothelium. Therefore, thrombosis seen in Covid and post Covid state is usually very extensive and difficult to treat. Extensive damage to endothelium and decreased mobilization of patient because of extreme weakness causing stagnation of blood in lower limb, create ground for deep vein thrombosis It can occur inspite of anticoagulation.

When cytokine storm sets in - any thing can happen . Although if appropriately treated in time it is rare . If treatment is not proper as per the covid protocols,- it can happen - even if anti- coagulation has been done in moderate to severe cases

Amid Covid, anything can be expected since all treatment strategies are trials and very limited research available. Everyone is learning. I think embolism can happen despite anticoagulant therapy if anticoagulation is not well titrated or if inflammation is very severe

This may be explained by direct and indirect pathologic consequences of COVID-19, complement activation, cytokine release, endothelial dysfunction, and interactions between different types of blood cells.


Yes can happen

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