Bronchial Artery Embolization for Life-Threatening Hemoptysis in COVID-19 Patients

Abstract

After the outbreak of the novel coronavirus at the end of December 2019 in China, it has become a global pandemic. Clinical manifestation of coronavirus disease 2019 (COVID-19) has a wide range of presentations from asymptomatic to severe multi-organ involvement. Hemoptysis appears to be one of the major manifestations of severe acute respiratory syndrome that is related to COVID-19 infection. The occurrence of hemoptysis is multifactorial. However, massive hemoptysis is usually related to pulmonary aspergillosis or severe bronchiectasis due to corticosteroid pulse therapy that can be life-threatening. This manuscript presents five cases of successful life-saving bronchial artery embolization in patients with COVID-19 infection who were suffering from massive hemoptysis that was mostly related to aspergillosis and bronchiectasis. These cases are followed by a review of the literature.

Keywords

SARS-Cov-2 - invasive pulmonary aspergillosis - angioembolization - bronchiectasis - polyvinyl alcohol - embolization - hemoptysis

Publication History

Article published online:
19 May 2022

• References

• 1 Zhu H, Wei L, Niu P. The novel coronavirus outbreak in Wuhan, China. Glob Health Res Policy 2020; 5: 6
• 2 Tzotzos SJ, Fischer B, Fischer H, Zeitlinger M. Incidence of ARDS and outcomes in hospitalized patients with COVID-19: a global literature survey. Crit Care 2020; 24 (01) 516
• 3 Sun P, Ren J, Li K, Qie S, Liu Z, Xi J. Response to: sore throat in COVID-19: comment on “Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta-analysis”. J Med Virol 2020; 92 (07) 716-718
• 4 Corey R. Hemoptysis. In: Walker HK, Hall WD, Hurst JW. eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed.. Boston: Butterworths; 1990: 211-213
• 5 Sokouti M, Montazeri V. Massive life-threatening hemoptysis from pulmonary hydatid cysts: a 13 - Year experience from an endemic area. Tanaffos 2008; 7: 41-46
• 6 Selvaraj V, Dapaah-Afriyie K. Lung cavitation due to COVID-19 pneumonia. BMJ Case Rep 2020; 13 (07) e237245
• 7 Bidwell JL, Pachner RW. Hemoptysis: diagnosis and management. Am Fam Physician 2005; 72 (07) 1253-1260
• 8 Lapostolle F, Schneider E, Vianu I. et al. Clinical features of 1487 COVID-19 patients with outpatient management in the Greater Paris: the COVID-call study. Intern Emerg Med 2020; 15 (05) 813-817
• 9 Chong WH, Neu KP. Incidence, diagnosis and outcomes of COVID-19-associated pulmonary aspergillosis (CAPA): a systematic review. J Hosp Infect 2021; 113: 115-129
• 10 Keshmiri MS, Shafaghi S, Sharif-Kashani B. et al. Preemptive non-selective bronchial artery angioembolization to reduce recurrence rate of hemoptysis. Multidiscip Respir Med 2020; 15 (01) 723
• 11 Dohen-Bécue F, Salez F, Ramon P. et al. [Management of hemoptysis in invasive pulmonary aspergillosis]. Rev Mal Respir 1998; 15 (06) 791-796 (French)
• 12 Gupta A, Sands M, Chauhan NR. Massive hemoptysis in pulmonary infections: bronchial artery embolization. J Thorac Dis 2018; 10 (Suppl. 28) S3458-S3464
• 13 Seyyedi SR, Sadeghipour P, Sadr M. et al. Outcomes and complications of bronchial angioembolization in patients with massive hemoptysis. Tanaffos 2019; 18 (04) 310-314
• 14 Yoon W. Embolic agents used for bronchial artery embolisation in massive haemoptysis. Expert Opin Pharmacother 2004; 5 (02) 361-367
• 15 Keshmiri MS, Sharifkashani B, Serati A. et al. Superselective angioembolisation: a report of two rare cases of hemoptysis. Int J Cardiovasc Pract 2019; 4: 19-21
• 16 Murgo S, Lheureux O, Taccone F, Vouche M, Golzarian J. Haemoptysis treated by bronchial artery embolisation in severe acute respiratory syndrome coronavirus 2: case report. CVIR Endovasc 2020; 3 (01) 61
• 17 Peys E, Stevens D, Weygaerde YV. et al. Haemoptysis as the first presentation of COVID-19: a case report. BMC Pulm Med 2020; 20 (01) 275
• 18 Koehler P, Cornely OA, Böttiger BW. et al. COVID-19 associated pulmonary aspergillosis. Mycoses 2020; 63 (06) 528-534
• 19 Pasula S, Chandrasekar P. Spontaneous hemoptysis in a patient with COVID-19. Chest 2021; 160 (01) e39-e44
• 20 Sato L, Kinoshita N, Nakamoto T, Ohmagari N. Hemoptysis and a newly formed lung bulla in a case of convalescent COVID-19 pneumonia. Intern Med 2021; 60 (05) 803-805
• 21 Maruhashi T, Wada T, Masuda T, Yamaoka K, Asari Y. Tracheal tube obstruction due to hemoptysis associated with pulmonary infarction in a patient with severe COVID-19 pneumonia. Cureus 2021; 13 (02) e13599
• 22 Argun Barış S, Coşkun İS, Selvi G, Boyacı H, Başyiğit İ. Case series of COVID-19 presenting with massive hemoptysis. Turk Thorac J 2020; 21 (06) 454-456
• 23 Seyyedi SR, Sadr M, Chitsazan M, Abedini A, Sharif-Kashani B. Angioembolization in massive hemoptysis for a patient with acute coronary syndrome and history of hydatid cyst. J Cardiol Cases 2020; 23 (05) 231-233