Arterial thrombosis and coronavirus disease 2019 in a patient with cancer

Nassabein, Rami; Routy, Bertrand; Blais, Normand; Ayoub, Jean-Pierre; Tehfé, Mustapha

doi:10.1016/j.ejca.2020.05.002

Cited by 4 publications

(7 citation statements)

References 6 publications

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“…A total of 27 studies describing arterial thrombotic events in 90 COVID-19 patients were included. 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 The majority of the studies were from Europe (23 studies; France: 8, Italy: 7, Spain: 4, the United Kingdom: 3, and the Netherlands: 1), whereas the rest were from North America (the United States of America: 3 and Canada: 1). Of the included studies, 5 were cohort, 5 were case series, and the rest were case reports.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of the AT patients had pre-existing conditions, such as hypertension, 18 , 19 , 21 , 23 , 28 , 31 cardiovascular disease, 18 , 19 , 20 , 24 atrial fibrillation, 18 , 19 , 25 chronic kidney disease, 18 , 19 , 25 chronic obstructive lung disease, 18 , 19 , 25 , 35 obesity, 18 hyperlipidemia, 22 , 23 diabetes mellitus, 13 , 18 , 19 , 23 , 24 , 28 , 35 asthma, 13 leukemia, 14 , 29 and renal tubular acidosis. 13 Only 5 studies reported AT in patients with no comorbid conditions.…”

Section: Resultsmentioning

confidence: 99%

“…AT was incidentally discovered in 2 patients. 27 , 31 It was symptomatic in the rest, manifesting as acute limb ischemia, 11 , 12 , 18 , 19 , 21 , 24 , 25 , 26 , 30 , 32 , 35 , 37 acute cerebral ischemia, 11 , 13 , 14 , 15 , 19 , 21 , 22 , 24 , 28 , 29 acute mesenteric ischemia, 14 , 16 , 17 , 19 , 24 , 37 and acute myocardial ischemia. 19 , 23 , 33 , 34 …”

Section: Resultsmentioning

confidence: 99%

“… 30 Spain Case series 4 4 (100) 71 3 (75) Lower limb: infrapopliteal (all distal veins in one leg [1 patient]; all distal veins in both legs [2 patients]; femoropopliteal [1 patient]), upper limb: radioulnar (1 patient) CT angiography VTE Not reported 0 (0) Nassabein et al. 31 Canada Case report 1 1 (100) 66 0 (0) Aorta (descending thoracic and abdominal) CT angiography None HTN, osteopenia 0 (0) Perini et al. 32 Italy Case series 2 2 (100) 37 and 53 2 (100) Lower limb (aortoiliac); upper limb (humeral artery) CT angiography None None 1 (50) Rey et al.…”

Section: Methodsmentioning

confidence: 99%

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Arterial Thrombosis in Coronavirus Disease 2019 Patients: A Rapid Systematic Review

Cheruiyot

Kipkorir

Ngure

et al. 2021

Annals of Vascular Surgery

144

153

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Background Emerging evidence suggests that severe form of coronavirus disease 2019 (COVID-19) is mediated, in part, by a hypercoagulable state characterized by micro- and macro-vascular thrombotic angiopathy. Although venous thrombotic events in COVID-19 patients have been well described, data on arterial thrombosis (AT) in these patients is still limited. We, therefore, conducted a rapid systematic review of current scientific literature to identify and consolidate evidence of AT in COVID-19 patients. Methods A systematic search of literature was conducted between November 1, 2019, and June 9, 2020, on PubMed and China National Knowledge Infrastructure to identify potentially eligible studies. Results A total of 27 studies (5 cohort, 5 case series, and 17 case reports) describing arterial thrombotic events in 90 COVID-19 patients were included. The pooled incidence of AT in severe/critically ill intensive care unit–admitted COVID-19 patients across the 5 cohort studies was 4.4% (95% confidence interval 2.8–6.4). Most of the patients were male, elderly, and had comorbidities. AT was symptomatic in >95% of these patients and involved multiple arteries in approximately 18% of patients. The anatomical distribution of arterial thrombotic events was wide, occurring in limb arteries (39%), cerebral arteries (24%), great vessels (aorta, common iliac, common carotid, and brachiocephalic trunk; 19%), coronary arteries (9%), and superior mesenteric artery (8%). The mortality rate in these patients is approximately 20%. Conclusions AT occurs in approximately 4% of critically ill COVID-19 patients. It often presents symptomatically and can affect multiple arteries. Further investigation of the underlying mechanism of AT in COVID-19 would be needed to clarify possible therapeutic targets.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Arterial Thrombosis in Coronavirus Disease 2019 Patients: A Rapid Systematic Review

Cheruiyot

Kipkorir

Ngure

et al. 2021

Annals of Vascular Surgery

144

153

View full text Add to dashboard Cite

show abstract

“…Fibrinolytic interventional therapy using tissue plasminogen activator (tPA) has been indicated to be beneficial when used as a rescue therapy in patients who have acute respiratory distress syndrome (ARDS) due to COVID-19 [39] . Low molecular weight heparin and other anticoagulants should also be contemplated as a prophylactic measure in cancer patients with COVID-19 infection, as they have been effective in preventing thrombosis in cancer patients previously [40] , [41] , [42] . Nevertheless, these exploratory measures should be considered in the context of mixed evidence, as one retrospective cohort of 398 subjects found similar rates of thrombotic and hemorrhagic events in cancer and non-cancer cohorts [43] .…”

Section: Introductionmentioning

confidence: 99%