Portal Vein Thrombosis Might Develop by COVID-19 Infection or Vaccination: A Systematic Review of Case-Report Studies

Abstract

Background and Objective: Infection by the novel coronavirus disease 2019 (COVID-19) has been associated with different types of thrombotic complications same as portal vein thrombosis (PVT). However, by emerging vaccines of COVID, the thrombosis did not seem to be concerning anymore. Until new findings showed that, the vaccine of COVID itself can cause PVT.Method: We performed an electronic search in PubMed, Scopus, and Web of Sciences to evaluate the possibility of occurring PVT due to infection and vaccination of COVID-19. The results were reported in a narrative method and categorized into tables.Result: Overall, 40 cases of PVT from 34 studies were reviewed in this article. The prevalence of PVT following COVID-19 was more remarkable in males. However, it was more common in females after vaccinations of COVID-19 in the reviewed cases. Regardless of etiology, 20 of PVT cases reviewed in this article had at least one comorbidity. The most common clinical presentation was abdominal pain (AP). After anticoagulant therapies, most of the patients improved or discharged.Conclusion: As long as the laboratory findings are not appropriate enough to predict PVT, the diagnosis of this complication with whatever underlying reason is challengeable, while rapid diagnosis and treatment of that are vital. Therefore, by providing available data in an organized way, we aimed to prepare the information of infected patients for better and easier future diagnosis of PVT in new cases.

Portal Vein Thrombosis Secondary to COVID-19: A Rare Complication

“…General symptoms like cough and fever are common, but numerous complications like respiratory, cardiovascular, and musculoskeletal issues and thrombosis are less common [ 4 ]. A meta-analysis of 50,466 patients with COVID-19 found that 96.6% of the patients had abnormal CT scans, a finding found in our patient [ 2 , 5 ]. The literature suggests that COVID-19 increases the risk of coagulation abnormalities, particularly venous thromboembolism (VTE), disseminated intravascular coagulation (DIC), deep vein thrombosis (DVT), and portal vein thrombosis (PVT) [ 2 , 6 ].…”

“…Coronavirus disease 2019 (COVID-19), which emerged in Wuhan, China, at the end of 2019, has been classified as a pandemic. The virus has impacted nearly 240 million people across the globe, ranging from an asymptomatic carrier state to respiratory symptoms, cardiovascular abnormalities, neuropsychiatric symptoms, hematologic manifestation, particularly portal vein thrombosis (PVT), and multiorgan failure to death [ 1 - 2 ]. The purpose of this report/study is to increase awareness of this rare complication of COVID-19 (PVT).…”

Acute hepatitis with portal and mesenteric vein thrombosis revealing SARS-CoV-2 infection: Case report and literature review

“…Venous and arterial thromboembolism can occur in patients with SARS-CoV-2 viral infection because of its high thrombotic potential. Other types of coagulation disorders can be associated such as disseminated intravascular coagulation (DIC) [ 21 ].…”

“…The portal and mesenteric vein thrombosis are extremely rare complications and unusual main manifestations of COVID-19 developed within 2 weeks from admission. The mechanism of these conditions is the same which leads to the liver injury [ 21 ].…”

“…The immediate anticoagulant therapy (Heparin and low-molecular-weight heparin) is recommended treatment to prevent progression of thrombosis of the portal vein to intestinal infarction [ 21 ]. To our best knowledge, few cases of portal vein thrombosis associated with mesenteric vein thrombosis caused by COVID-19 were reported in the literature.…”