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Multiple Arterial Thrombosis in a 78-Year-Old Patient: Catastrophic Thrombotic Syndrome in COVID-19
David Kenizou1, Clemence Perrin1, Ines Harzallah2
1Cardiology Department, Mulhouse Region/South of Alsace Hospital, Hôpital E. Muller, Mulhouse, France.
Insights
This case report details a patient with coronavirus disease 2019 (COVID-19) who developed severe arterial thrombosis. The findings suggest COVID-19 can trigger significant endothelial activation leading to catastrophic thrombotic events.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Pathology
Background:
- Coronavirus disease 2019 (COVID-19) is a global pandemic with diverse clinical manifestations.
- Vascular complications, including thrombosis, have been reported in COVID-19 patients.
- Endothelial dysfunction is increasingly recognized as a key mechanism in COVID-19 pathogenesis.
Observation:
- A patient admitted for COVID-19 developed multiple, widespread arterial thromboses on day 9 of hospitalization.
- Thrombotic events occurred in the aorta, renal arteries, humeral arteries, and pulmonary arteries.
- Comprehensive laboratory workup revealed no pre-existing prothrombotic conditions.
Findings:
- The patient presented with an extreme form of catastrophic thrombotic syndrome.
- The absence of underlying prothrombotic disease points towards an acquired cause.
- Severe arterial thrombosis was strongly associated with COVID-19 infection.
Implications:
- This case highlights the potential for COVID-19 to induce severe arterial thrombosis through intense endothelial activation.
- Understanding COVID-19-associated endothelial dysfunction is critical for managing vascular complications.
- Further research is needed to elucidate the mechanisms linking COVID-19 to arterial thrombosis.
Abstract:
We describe a patient with coronavirus disease 2019 (COVID-19) and multiple concomitant thromboses occurring on the 9th day of hospital stay. Thromboses were found in distinct zones of the aorta, as well as in the renal, humeral, and pulmonary arteries. The extensive biological workup performed following this catastrophic thrombotic syndrome found no evidence for underlying prothrombotic disease. In light of current evidence regarding endothelium abnormalities related to COVID-19, this extreme case of catastrophic thrombotic syndrome suggests that COVID-19 can induce severe arterial thrombosis following intense endothelial activation.
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