Anterior Abdominal Wall Ecchymosis in COVID-19 Patient Following Enoxaparin Use

Background: The role of anticoagulation in preventing and treating thromboembolic events due to presence of micro thrombosis that may affect various end-organs especially in coronavirus disease-19 (COVID-19). Patients receiving some form of anticoagulation therapy are predisposed to more risks of bleeding complications. These bleeding may range from minor to major, or even life-threatening events. Purpose: Low molecular weight heparin (LMWH) is one of the commonly used treatment modalities in COVID-19 and its complications are thrombocytopenia, anemia, bruises, and the rare ones are ecchymosis and/ or hematoma. Case presentation: A 75-year-old male COVID-19 patient weighing 85 kg was admitted to our intensive care unit (ICU) with shortness of breath, dry cough, and myalgia. On the 10th day, he develops ecchymotic patches over the anterior abdominal wall following administration of subcutaneous enoxaparin. This case describes the importance ofindividualizing the dose ofLMWH based on several risk factors.