Case of right ventricular and aortic thrombi in a patient with severe COVID-19

Afari, Henrietta; Tefera, Leben; Rosovsky, Rachel

doi:10.1136/bcr-2020-240745

Cited by 5 publications

(3 citation statements)

References 31 publications

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“…A total of 55 patients from the database research and 1 patient from our facility were included. 9 10 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 38 39 40 41 42 43 44 45 46 Of the included studies, 12 were case series and 26 were case reports. Essential characteristics of the included patients are outlined in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

Aortic Thrombosis following COVID-19: A Systematic Review

Petrov¹,

Romera²,

Wilbring³

et al. 2022

Thorac Cardiovasc Surg

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Background Arterial and venous thromboses associated with the coronavirus disease 2019 (COVID-19) have been well described. These events are caused by a hypercoagulable state due to endotheliopathy and infection-driven coagulopathy. There has been an ever-increasing number of documented cases of aortic thrombosis (AoT) in COVID-19 patients. We conducted a systematic review of current scientific literature to identify and consolidate evidence of AoT in COVID-19 patients. Methods A systematic review of literature was conducted between March 15, 2020, and May 1, 2021, on PubMed and Cochrane databases. Additionally, a case from our facility was included. Results A total of 38 studies (12 case series and 26 case reports) and a case from our facility describing AoT in 56 COVID-19 patients were included. Patients were aged 64.8 ± 10.5 years, were predominantly male (75%), and had several comorbidities. AoT was symptomatic in 82,14% of patients; however, when D dimers were reported, they were significantly elevated even in otherwise asymptomatic patients. Most patients had no previous history of aortic disease. Thrombosis was described in all parts of the aorta, with several cases reporting multiple locations. The median reported time until development of AoT was 10 days. Peripheral thrombosis occurred in 73.21% of cases, most commonly causing lower limb ischemia. Mortality rate was 30.4%. Conclusions AoT can occur with no clinical symptoms or as a primary symptom in otherwise asymptomatic COVID-19 patients. D dimers are a highly sensitive diagnostic tool. Diagnosis of this condition prior to development of complications could be instrumental in saving many lives.

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Section: Resultsmentioning

confidence: 99%

Aortic Thrombosis following COVID-19: A Systematic Review

Petrov¹,

Romera²,

Wilbring³

et al. 2022

Thorac Cardiovasc Surg

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“…Although thrombus formation within the right atrium, right ventricle can lead to consecutive pulmonary embolism, this issue is under-reported in the scientific literature and clinical guidelines [ 22 , 23 , 24 , 25 ]. There are also few data on aortic thrombosis in COVID-19 and its combination with venous thrombosis [ 24 , 26 , 27 , 28 , 29 , 30 ]. The results of our study demonstrated that in situ pulmonary artery thrombosis is the most common thrombotic complication identified postmortem.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of Thrombotic Complications in Fatal Cases of COVID-19: Focus on Pulmonary Artery Thrombosis In Situ

Babkina

Yadgarov

Волков

et al. 2023

Viruses

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COVID-19-related thrombosis affects the venous and arterial systems. Data from 156 autopsies of COVID-19 patients were retrospectively analyzed to investigate the pattern of thrombotic complications and factors associated with pulmonary artery thrombosis and thromboembolism. Thrombotic complications were observed in a significant proportion (n = 68, 44%), with pulmonary artery thrombosis the most frequently identified thrombotic event (42, 27%). Multivariate analysis revealed that the length of hospital stay (OR 1.1, p = 0.004), neutrophil infiltration in the alveolar spaces (OR 3.6, p = 0.002), and the absence of hyaline membranes (OR 0.1, p = 0.01) were associated with thrombotic complications. Neutrophil infiltration in the alveolar spaces (OR 8, p < 0.001) and the absence of hyaline membranes (OR 0.1, p = 0.003) were also independent predictors of pulmonary artery thrombosis. The association of pulmonary artery thrombosis with an absence of hyaline membranes suggests it occurs later in the course of COVID-19 infection. As neutrophil infiltration in the alveolar spaces may indicate bacterial infection, our studies suggest the consideration of bacterial infections in these critically ill patients.

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“…9,10 High index of suspicion and early treatment is very much necessary to avoid poor outcomes and mortality in such severe cases. 11,12 In severe cases of COVID-19 infections, especially with right heart thrombus and pulmonary embolism, thrombolysis should be done as soon as possible. 13 Additional research is warranted to explore the screening and thrombolysis approaches, particularly in cases of severe COVID-19 infection accompanied by RVT.…”

Section: Casementioning

confidence: 99%

Right Ventricle Thrombus and COVID-19 Infection: An Uncommon Report of Three Cases

Mittal,

Patel,

Patel

et al. 2023

Indian Journal of Critical Care Case Report

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Case seriesthrombolyzed with 100 mg injection actilyse [recombinant tissue plasminogen activator (rt-PA)] over 2 hours. 2D-echo was repeated again (Video 2) and showed reduction in the size of thrombus. After 10 days, oxygen requirement was reduced to 5-6 L/minute, and in another 10-11 days, patient was shifted out of ICU and was finally discharged after 24 days of admission. Following discharge, patient was advised to take dabigatran 150 mg 12 hourly.

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Case of right ventricular and aortic thrombi in a patient with severe COVID-19

Cited by 5 publications

References 31 publications

Aortic Thrombosis following COVID-19: A Systematic Review

Aortic Thrombosis following COVID-19: A Systematic Review

Spectrum of Thrombotic Complications in Fatal Cases of COVID-19: Focus on Pulmonary Artery Thrombosis In Situ

Right Ventricle Thrombus and COVID-19 Infection: An Uncommon Report of Three Cases

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