Microthrombi in skin biopsy of a patient with COVID-19

Shehi, Elona; Chilimuri, Sridhar; Shin, Dongmin; Patel, Madanmohan; Ali, Nisha; Niazi, Masooma

doi:10.1016/j.jdcr.2020.10.009

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…The high rates of microthrombosis are not limited to the lungs; they also have been reported in the heart 53 and skin. 54 Imaging studies demonstrate that thrombotic lesions in COVID-19 are smaller and more peripherally located compared with those in non-COVID acute PE, suggesting that some filling defects on CTPA, particularly isolated subsegmental PE, may reflect in situ pulmonary thrombosis instead of the typical embolization of thrombi originating from peripheral DVT. 12,55 Mirsadraee et al 26 reported that of the critically ill patients with COVID-19 found to have pulmonary thrombosis via screening CTPA, 77% did not have radiologic evidence of peripheral DVT.…”

Section: Endothelial Injurymentioning

confidence: 95%

Pulmonary Thrombosis and Thromboembolism in COVID-19

Poor

2021

Chest

113

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Coronavirus disease 2019 (COVID-19), the disease responsible for the devastating pandemic that began at the end of 2019, has been associated with a significantly increased risk of pulmonary thrombosis, even in patients receiving prophylactic anticoagulation. The predilection for thrombosis in COVID-19 may be driven by at least two distinct, but interrelated, processes: a hypercoagulable state responsible for large vessel thrombosis and thromboembolism, and direct vascular and endothelial injury responsible for in situ microvascular thrombosis. The presence of pulmonary thrombosis may explain why hypoxemia is out of proportion to impairment in lung compliance in some patients with COVID-19 pneumonia. Because pulmonary embolism and COVID-19 pneumonia share many signs and symptoms, diagnosing pulmonary embolism in patients with COVID-19 can be challenging. Given the high mortality and morbidity associated with severe COVID-19, and the concern that aspects of the disease may be driven by thrombosis, many hospital systems have instituted aggressive anticoagulation protocols above standard venous thromboembolism prophylaxis. In this review, the epidemiology, pathophysiology, diagnosis, and treatment of COVID-19 pulmonary thrombosis and thromboembolism are discussed.

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Section: Endothelial Injurymentioning

confidence: 95%

Pulmonary Thrombosis and Thromboembolism in COVID-19

Poor

2021

Chest

113

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“…Additionally, diverse cardiac histopathologic findings, including endothelial cell damage and inflammatory cell infiltrates without associated cardiac necrosis (10)(11)(12), have been described on autopsy of COVID-19 decedents but at variable prevalence. Subsequently, the detection of microvascular thrombi in the hearts (13,14), lungs (15)(16)(17)(18)(19), liver (20), brain (21), and skin (22) of COVID-19 patients have raised the possibility that, in severe cases, COVID-19 may be more akin to a systemic illness. Such reports of multiorgan microthrombi, along with a high incidence of venous thromboembolism in severe and critical COVID-19, have led investigators to hypothesize that severe SARS-CoV-2 infection promotes a hypercoagulable state, referred to as COVID-19-associated coagulopathy (23)(24)(25)(26)(27).…”

Section: Introductionmentioning

confidence: 99%

Clinico-histopathologic and single-nuclei RNA-sequencing insights into cardiac injury and microthrombi in critical COVID-19

et al. 2022

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“…However, a biopsy showing fibrin microthrombi within the small vessels has also been reported, suggesting a more complex pathophysiology may be operational in some cases. 49 …”

Section: Viral Exanthem/inflammatory Eruptionsmentioning

confidence: 99%

Cutaneous Manifestations of COVID-19 in the Inpatient Setting

Mytrang

Stewart

Harp

2021

Dermatologic Clinics

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Synopsis Cutaneous findings have increasingly been reported in patients with coronavirus disease 2019 (COVID-19). This review discusses associated skin findings in COVID-19 patients in the inpatient setting, ranging from vasculopathy-related lesions associated with high hospitalization rate and poor prognosis to inflammatory vesicular and urticarial eruptions that are rarely associated with prolonged hospitalization. We also discuss other reported COVID-19 cutaneous manifestations such as Sweet's syndrome, purpuric eruptions, and Multisystem Inflammatory Syndrome in Children (MIS-C). While the relationship between dermatological changes and COVID-19 disease progression is not fully elucidated, familiarity with cutaneous manifestations is valuable for physicians caring for hospitalized COVID-19 patients and may help improve disease recognition and care.

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Microthrombi in skin biopsy of a patient with COVID-19

Cited by 8 publications

References 13 publications

Pulmonary Thrombosis and Thromboembolism in COVID-19

Pulmonary Thrombosis and Thromboembolism in COVID-19

Clinico-histopathologic and single-nuclei RNA-sequencing insights into cardiac injury and microthrombi in critical COVID-19

Cutaneous Manifestations of COVID-19 in the Inpatient Setting

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