A rare case of multiple aortic thromboses associated with severe COVID-19 infection

Kugasia, Irfanali R; Ijaz, Mohsin; Khan, Ahsan; Jalil, Bilal

doi:10.1136/bcr-2021-242196

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…Importantly, our case demonstrated that the functional asplenia may persist even months after the acute phase of splenic infarct highlighting the need for continuous antibiotic treatment, correct administration of vaccines and vigilance for potential infections. Aortic thrombosis, another complication rarely seen in the acute COVID-19 sequelae [ 7 , 19 , 20 ] was also reported at our patient and was attributed to severe COVID-19 pneumonia inducing prothrombotic state through one of the aforementioned mechanisms. Notably, antiphospholipid antibodies frequently seen in other cases with arterial thrombotic complications were not detected in our patient, nor were anticardiolipin antibodies that could partially explain the acquired coagulopathy in this patient [ 21 , 22 ].…”

Section: Discussionsupporting

confidence: 65%

A COVID-19 Patient with Simultaneous Renal Infarct, Splenic Infarct and Aortic Thrombosis during the Severe Disease

et al. 2022

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with a high incidence of arterial and venous thrombotic complications. However, thromboembolic events in unusual sites such as limb and visceral arterial ischemia are reported rarely in the literature. Herein, we describe a rare case of a patient with severe coronavirus disease 2019 (COVID-19) infection who experienced severe abdominal pain during the hospitalization and presented simultaneously renal artery, splenic artery and vein as well as aortic thrombi despite prophylactic antithrombotic treatment. Information about his follow-up post discharge is also provided. This case report raises significant clinical implications regarding the correct dose of antithrombotic treatment during the acute phase of the severe COVID-19 infection and highlights the need for incessant vigilance in order to detect thrombosis at unusual sites as a possible diagnosis when severe abdominal pain is present in severe COVID-19 patients.

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Section: Discussionsupporting

confidence: 65%

A COVID-19 Patient with Simultaneous Renal Infarct, Splenic Infarct and Aortic Thrombosis during the Severe Disease

et al. 2022

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Aortic arch thrombosis complicated by an embolic stroke in a patient with COVID-19: A case report

Al-Mashdali

Al-Dubai

Al-warqi

2021

Annals of Medicine &Amp; Surgery

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Introduction Aortic thrombosis is an uncommon condition with serious embolic complications. COVID-19 is currently recognized to be associated with both venous and arterial thrombosis. However, only a limited number of COVID-19 cases associated with aortic thrombosis have been reported in the literature since the beginning of the pandemic. Case presentation A 66-year-old lady was admitted to our hospital with acute ischemic stroke. Floating aortic arch thrombus was detected incidentally on CT imaging. Interestingly, the patient reported a history of fever and cough and was found to have COVID-19 pneumonia based on nasopharyngeal polymerase chain reaction (PCR) and imaging. The patient received three months of anticoagulant therapy, and repeated imaging study did not reveal any aortic thrombus. Clinical discussion COVID-19 related aortic thrombosis has been reported chiefly in severe cases. The SARS-CoV-2 can directly infect the endothelium of the vessels, which might explain the occurrence of arterial thrombosis in milder COVID-19 cases with the absence of the hyperinflammatory state. The management guideline for aortic thrombosis is scarce and based only on case reports and series. Conclusion Aortic thrombosis is a devastating condition that can be easily missed without clinical suspicion. Our patient developed acute ischemic stroke, most likely embolic originating from the aortic thrombus. The clinician should consider this condition in any COVID-19 patient presenting with thromboembolic events, such as stroke or acute limb ischemia. Further study is required to explain the pathophysiology of arterial/venous thrombosis in mild-moderate COVID-19 cases.

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A rare case of multiple aortic thromboses associated with severe COVID-19 infection

Cited by 2 publications

References 4 publications

A COVID-19 Patient with Simultaneous Renal Infarct, Splenic Infarct and Aortic Thrombosis during the Severe Disease

A COVID-19 Patient with Simultaneous Renal Infarct, Splenic Infarct and Aortic Thrombosis during the Severe Disease

Aortic arch thrombosis complicated by an embolic stroke in a patient with COVID-19: A case report

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