Venous sinus thrombosis during COVID-19 infection in pregnancy: a case report

Abstract

The effects of COVID-19 are not limited to the lungs alone. After the virus enters the body, it causes various symptoms through viremia. 1 COVID-19 has been implicated in occurrences of cardiovascular and thromboembolic complications due to systemic inflammation and coagulopathy, in the light of the increasing amount of data that has become available over time. 2-8 On the other hand, some published papers have argued that the signs and symptoms of severe COVID-19 infection are more similar to the pathophysiology and phenotype of complement-mediated thrombotic microangiopathy (TMA), rather than to sepsis-induced coagulopathy or diffuse intravascular coagulation (DIC). 8 It has been suggested that COVID-19 predisposes patients to thrombotic pathological conditions in both the venous and the arterial circulation due to inflammation, platelet activation, endothelial dysfunction and stasis. 4 Nevertheless, cases of neurological and cardiac involvement in COVID-positive patients with TMA have also been reported. 9 While the mechanism for the susceptibility to thrombosis that has been seen among COVID-19 patients continues to be debated, we wanted through this report to share information regarding the common venous thrombus of the central nervous system that emerged during the subclinical course of COVID-19 in a pregnant patient, which caused rapid parenchymal infarction. CASE REPORT A 22-year-old patient who was 35 weeks pregnant was evaluated in the emergency department with a complaint of right-sided weakness. The COVID-19 polymerase chain reaction test was performed and was found to be positive. However, she did not have fever or respiratory distress and then was followed up at home without medication. The patient started to have throbbing headaches that did not respond to analgesic treatment (paracetamol 1000 mg/day) for four days. The intensity of her headaches gradually increased, such that she was being awakened from sleep, and this condition was accompanied by nausea and vomiting. After this four-day period, she again felt weakness on her right side when she woke up in the morning. Twelve hours later, she went back to the emergency department because her weakness was increasing. At the emergency department, the patient was found to be normotensive, conscious, cooperative and oriented in a neurological examination. No fundus examination was performed, given that she was COVID-positive. Examinations on the patient's visual field and vision showed normal results. Other cranial nerve examinations were normal. Her muscle strength ratio was 3/5 in the upper right extremity, 2/5 in the lower right extremity and 5/5 in the upper I

Thrombocytopenia and Intracranial Venous Sinus Thrombosis after “COVID-19 Vaccine AstraZeneca” Exposure

“…IVST is among the less frequent but well-documented sequelae of COVID-19 [11]. Gunduz (2021) [12] reported the case of a pregnant woman with COVID-19-associated IVST with antinuclear antibodies and heterozygous prothrombin mutation, indicating thrombophilia as a predisposing factor. Thrombophilia screening yielded positive results in several other patients [13], including the occurrence of transient antiphospholipid antibodies [14].…”

Pregnancy and neurologic complications of COVID‐19: A scoping review

“…Finally, we reviewed 18 case reports from the selected 17 papers (Tables 1 and 2 ). 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 …”

Coagulopatia em gestantes com COVID-19

“…Assim, os pacientes ficam predispostos às condições patológicas na circulação venosa e arterial, como a trombose. Os aumentos marcantes na fibrina/ fibrinogênio são sinais iniciais de coagulopatia por COVID-19 (Gunduz, 2021).…”