{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:24:06Z","timestamp":1777447446563,"version":"3.51.4"},"reference-count":5,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T00:00:00Z","timestamp":1646956800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>Coronavirus disease 2019 (COVID-19) is linked with a hypercoagulable state called COVID-19-associated coagulopathy (CAC). Due to elevated levels of factor VIII and fibrinogen as well as inflammation-linked hyperviscosity of blood, the risk for venous thromboembolism is increased in patients who have CAC. We report the case of a patient with recent COVID-19 infection and no other past medical history who presented after a motorcycle collision with left middle and distal femur fractures, who underwent retrograde intramedullary nailing, and then developed immediate massive bilateral pulmonary emboli. The patient was treated with tissue plasminogen activator administration via bilateral pulmonary artery thrombolysis catheters without improvement, and was then placed on venoarterial extracorporeal membrane oxygenation for subsequent cardiogenic shock. During a 58-day hospital stay, the patient recovered and was discharged with a good long-term prognosis. In this report, we discuss CAC, the role of surgical critical care in the management of the disease, and issues specific to this patient\u2019s disease process and treatment.<\/jats:p>","DOI":"10.1177\/00031348211047502","type":"journal-article","created":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T04:45:55Z","timestamp":1646973955000},"page":"1016-1017","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Coronavirus-Associated Coagulopathy After Trauma"],"prefix":"10.1177","volume":"88","author":[{"given":"Kevin D.","family":"Kirkland","sequence":"first","affiliation":[{"name":"Department of General Surgery, New Hanover Regional Medical Center, Wilmington, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William F.","family":"Powers","sequence":"additional","affiliation":[{"name":"Department of General Surgery, New Hanover Regional Medical Center, Wilmington, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Acquista","sequence":"additional","affiliation":[{"name":"Department of General Surgery, New Hanover Regional Medical Center, Wilmington, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy J.","family":"Novosel","sequence":"additional","affiliation":[{"name":"Department of General Surgery, New Hanover Regional Medical Center, Wilmington, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James R.","family":"Yon","sequence":"additional","affiliation":[{"name":"Department of General Surgery, New Hanover Regional Medical Center, Wilmington, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,3,11]]},"reference":[{"key":"bibr1-00031348211047502","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14850"},{"key":"bibr2-00031348211047502","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005544"},{"key":"bibr3-00031348211047502","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.08.2064"},{"key":"bibr4-00031348211047502","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004028"},{"key":"bibr5-00031348211047502","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2020-000557"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348211047502","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348211047502","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348211047502","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:34:26Z","timestamp":1777379666000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348211047502"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,11]]},"references-count":5,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1177\/00031348211047502"],"URL":"https:\/\/doi.org\/10.1177\/00031348211047502","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,11]]}}}