Arterial and venous abdominal thrombosis in a 79-year-old woman with COVID-19 pneumonia

Barry, Olivier de; Ahmed, Mekki; Diffre, Caroline; Seror, Martin; Hajjam, Mostafa El; Carlier, Robert

doi:10.1016/j.radcr.2020.04.055

Cited by 88 publications

(90 citation statements)

References 8 publications

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“…Initial reports from Italian centers showed the thrombotic complications of COVID-19. [4][5][6] A prothrombotic state, is noted in patients with severe COVID-19 illness, where increased fibrin and fibrin degradation products are noted. This has been shown to adversely affect outcomes.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Acute Lower Limb Ischemia Secondary to COVID-19

Veerasuri¹,

Kulkarni

Wilson

et al. 2020

Vasc Endovascular Surg

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COVID-19 has to date affected over 5 million people worldwide and caused in excess of 300000 deaths. One of the principal finding is that of a thrombotic tendency within the lungs leading to high mortality. There have been increasing number of reports of peripheral arterial thrombosis as well. Most cases of arterial thrombosis is noted in patient in intensive care setting. Here-in we report a case of acute bilateral lower limb arterial thrombosis in a patient recovering at home with mild COVID-19 symptoms, highlighting that patients with milder symptoms may also suffer from prothrombotic state resulting in acute arterial occlusions. Arterial thrombosis should be suspected in these patients despite the absence of predisposing factors.

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Section: Discussionmentioning

confidence: 99%

Bilateral Acute Lower Limb Ischemia Secondary to COVID-19

Veerasuri¹,

Kulkarni

Wilson

et al. 2020

Vasc Endovascular Surg

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“…of the superior mesenteric vessels) (ref. 19 ). Even unenhanced computed tomography scan can signal indirect signs of thrombosis, which the radiologist must pay attention to 19 .…”

Section: Arterial and Venous Thrombosis And Hemorrhagesmentioning

confidence: 99%

“…19 ). Even unenhanced computed tomography scan can signal indirect signs of thrombosis, which the radiologist must pay attention to 19 . But the first clinical manifestation of SARS-CoV-2 infection may also be a thrombotic event, such as: venous thromboembolism, pulmonary embolism, carotid artery thrombosis, stroke, cerebral venous sinus thrombosis, or coronary thrombosis 20 .…”

Section: Arterial and Venous Thrombosis And Hemorrhagesmentioning

confidence: 99%

Coagulation disorders in SARS-CoV-2 infection

Mihăilă¹,

Mihaila²

2020

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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A better understanding of the pathogenetic mechanisms triggered by SARS-CoV-2 infection may contribute to a more effective management of patients with COVID-19. Coagulation dysfunction is a key pathogenetic element of this disease as well as a challenge for practitioners. Marked inflammatory process found in severe forms of COVID-19, the complement activation, the cytokine storm, and disruption of the renin-angiotensin-aldosterone system are involved in the onset of thrombotic microangiopathy and large vessel coagulopathy. Virus-induced procoagulant activity occurs at the systemic level. Intravascular microthrombi disrupt vascularization in various tissues and organs, contributing to the occurrence of multiorgan failure and explain the higher morbidity and all-cause mortality of patients. It is estimated that almost 20% of patients with COVID-19 have significant coagulation disorders, and about a quarter of those hospitalized in intensive care units are prone to develop thrombosis events under prophylactic anticoagulant treatment. Some of patients who have been immunized after healing from the SARS-CoV-2 infection have a hypercoagulable state and are prone to develop thrombosis. Hypercoagulability is supported by thrombelastographic analysis: patients have an acceleration of the propagation phase of blood clot formation and higher clot strength. Markers of coagulation dysfunction in SARS-CoV2 are: decreased platelet count, increased INR, presence of fibrin degradation products, and especially higher plasma levels of D-dimers, which predict unfavorable outcome in these patients. Age, pre-existing diseases and associated risk factors, together with careful monitoring of clinical evolution and laboratory parameters allow the choice of the best personalized prophylactic or curative anticoagulant treatment.

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“…Till now, only ve cases of SMA thrombosis in COVID-19 positive patients are reported in the world till now (3,2,1 patient in Strasbourg, Paris and Italy, respectively) [4][5][6]. Of these, one patient with multiple comorbidities was managed conservatively but did not survive.…”

Section: Discussionmentioning

confidence: 99%

Superior Mesenteric Artery thrombosis in COVID-19 pneumonia: An underestimated diagnosis - First case report in Asia

Karna

Panda

Maurya

et al. 2020

Preprint

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The COVID-19 disease caused by novel Coronavirus was first reported in Wuhan, China in December 2019 with 5% patients having severe lung injury. Though this disease primarily presents as a lower respiratory tract infection, multiple digestive manifestations have been reported which are often overlooked. The present case report describes the unusual progression of COVID-19 disease from pneumonia to a procoagulant state leading to superior mesenteric artery thrombosis and subsequent gut ischemia necessitating emergency laparotomy. Coagulopathy in COVID-19 is due to an imbalance in the coagulation homeostasis with increase in thrombocytes in contrast to thrombocytopenia documented in cases of dissemination intravascular coagulation and sepsis. Early recognition of abdominal symptoms, diagnosis of pathology and timely surgical intervention may definitely improve outcome. In the management of any patient with COVID-19 disease, we advocate a comprehensive integrated approach with early recognition of digestive symptoms and their timely intervention which should run parallel to the respiratory management.

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Arterial and venous abdominal thrombosis in a 79-year-old woman with COVID-19 pneumonia

Cited by 88 publications

References 8 publications

Bilateral Acute Lower Limb Ischemia Secondary to COVID-19

Bilateral Acute Lower Limb Ischemia Secondary to COVID-19

Coagulation disorders in SARS-CoV-2 infection

Superior Mesenteric Artery thrombosis in COVID-19 pneumonia: An underestimated diagnosis - First case report in Asia

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