Deep venous thrombosis and acute pericarditis associated with severe acute respiratory syndrome coronavirus 2 infection in a Congolese infant with sickle cell disease: a case report

Abstract

Background Since the beginning of the pandemic, no severe pediatric coronavirus disease 2019 cases have been described in Congo. Case We studied a 3-month-old male child of Congolese origin who was admitted to the pediatric department with 7-day history of fever, unilateral lower leg swelling, and dyspnea. There was no known history of contact with a coronavirus disease 2019 patient, and all the family members were asymptomatic. Nasopharyngeal swabs done at admission did not detect severe acute respiratory syndrome coronavirus 2. However, serology tests for severe acute respiratory syndrome coronavirus 2 antibodies were positive for immunoglobulin M and negative for immunoglobulin G. Hemoglobin electrophoresis showed hemoglobin A1, hemoglobin A2, hemoglobin F, and hemoglobin S of 46.2%, 2.5%, 19.9%, and 38.4%, respectively. Chest X-ray showed retrocardiac pneumonia in the left lung, and Doppler ultrasound of the left lower limb showed a recent total femoropopliteal venous thrombosis. At day 10 of hospitalization, our patient had classical signs of cardiac tamponade with a voluminous pericardial effusion seen on echocardiographic examination and elevated C-reactive protein, compatible with a diagnosis of constrictive pericarditis. To the best of the authors’ knowledge, this is the first report of a case of plausible severe acute respiratory syndrome coronavirus 2 infection associated with venous thrombosis and acute pericarditis in Congo. Conclusion We hypothesized that this case of venous thrombosis and acute pericarditis in a Congolese child with heterozygous sickle cell disease was related to severe acute respiratory syndrome coronavirus 2 infection.

Impact of the SARS-CoV-2 infection in individuals with sickle cell disease: an integrative review

“…In fact, the hypercoagulability state typical of sickle cell disease and the capacity of COVID-19 to promote thromboembolic events are listed as reasons that could explain the possibly higher risk of adverse outcomes of the infection ( 52 , 72 , 99 ). Some studies suggest an elevated incidence of pulmonary embolism in people with sickle cell disease and COVID-19 ( 16 , 43 , 53 , 72 , 79 , 103 ). However, case series, such as those conducted by Mitchell et al ( 60 ) and Noisette et al ( 62 ), present divergent data in this regard.…”

“…Likewise, there is no consensus when it comes to prophylactic anticoagulation. Many authors consider it plausible to intensify these regimens among sickle cell patients, given the potentially increased risk for coagulation disorders in this group ( 94 , 103 ). Others, such as Singh et al ( 108 ), facing the evidence that the risks are similar to those observed in the general population, suggest that anticoagulation should be carried out rationally, following the guidelines adopted in each institution.…”