Acute Splenic Artery Thrombosis and Infarction Associated with COVID-19 Disease
Osama Qasim Agha1,2,3, Ryan Berryman1,2
1Department of Internal Medicine, Creighton University School of Medicine, Phoenix, Arizona, USA.
Insights
Severe COVID-19 patients may develop splenic thrombosis and infarction, even with prophylactic anticoagulation. This case highlights the need for aggressive anticoagulation strategies in high-risk individuals with coronavirus disease 2019.
Area of Science:
- Medicine
- Infectious Diseases
- Hematology
Background:
- Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, presents with diverse symptoms, from mild to severe respiratory failure.
- A hypercoagulable state is frequently observed in COVID-19 patients, prompting various anticoagulant prophylaxis recommendations.
- Splenic complications, including thrombosis and infarction, are rare but serious manifestations of severe COVID-19.
Abstract:
Coronavirus 2019 disease (COVID-19) is a viral illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It emerged in Wuhan, China, in December 2019 and has caused a widespread global pandemic. The symptoms of COVID-19 can vary from mild upper respiratory symptoms to severe pneumonia with hypoxemic respiratory failure. Multiple studies and reports have reported a hypercoagulable state associated with this disease, and various recommendations have emerged to guide the use of anticoagulants for prophylaxis. We are reporting a case of symptomatic acute splenic thrombosis causing splenic infarction in a patient suffering from a severe case of COVID-19 and despite the use of an intermediate dose of low-molecular-weight heparin (LMWH). The patient was treated with full-dose anticoagulation and was eventually discharged home on a direct oral anticoagulant.
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