Is SARS-CoV-2 infection an emerging risk factor for splanchnic venous thrombosis?

Abstract

OBJECTIVE: Thrombosis represents one of the most feared complications of the COronaVIrus Disease-2019 (COVID-19). Although pulmonary embolism and deep venous thrombosis are the most described complications, some investigations reported thrombotic localization also in the splanchnic venous district. METHODS: We describe the case of a patient with SARS-CoV-2 infection presenting with abdominal pain and diagnosed with portal vein thrombosis. In addition, we shortly review available literature supporting the possible role of COVID-19 as leading cause of splanchnic venous thrombosis. RESULTS: After in-depth diagnostic workup, we excluded the commonest causes of portal thrombosis and concluded that SARS-CoV-2 infection represented the main explanation of this finding. CONCLUSIONS: Our study warns the clinicians to maintain a high index of suspicion for thrombosis in patients diagnosed with SARS-CoV-2 infection manifesting gastrointestinal symptoms. An appropriate diagnostic work-up could allow to obtain an early diagnosis and consequently improve the clinical outcome of patients.

Multimodal ultrasound imaging with conventional B-mode, elastography, and parametric analysis of contrast-enhanced ultrasound (CEUS): A novel approach to assess small bowel manifestation in severe COVID-19 disease

“…There is growing evidence that the combination of endothelial dysfunction with a generalized inflammatory state and complement involvement may contribute to the overall pro-coagulative state described in COVID-19 patients. This leads to venular as well as to arteriolar occlusions [12,[41][42][43].…”

Ultrasound features of abdominal thrombosis in COVID 19 patients

“…Both small and large vessel thrombosis has been reported in patients with COVID-19 [16,17]. Published reports have mentioned VSM, PV, aortic, hepatic artery, splanchnic vein, portomensenteric and ovarian vein thrombosis as a result of the hypercoagulable state due COVID-19 [2,16,[18][19][20][21][22][23][24][25][26]. The digestive manifestations of a SARS-CoV-2 infection are varied and nonspecific.…”

Shedding Light on the Pathogenesis of Splanchnic Vein Thrombosis

“…In addition to pulmonary embolism and deep vein thrombosis [55], cases with thromboses in the splanchnic venous district have also been reported [54,56]. The correlation between SVT and COVID-19 is not age-dependent (involving both young and old people), but a small prevalence of the male sex was observed [54,56,57]. Most frequently, the portal vein has been involved.…”

“…SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is responsible for the systemic disease called coronavirus-2019 disease (COVID-19), characterized by general symptoms, pulmonary conditions (including ARDS) [52] and thromboembolism [53,54]. In addition to pulmonary embolism and deep vein thrombosis [55], cases with thromboses in the splanchnic venous district have also been reported [54,56]. The correlation between SVT and COVID-19 is not age-dependent (involving both young and old people), but a small prevalence of the male sex was observed [54,56,57].…”