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Systemic arterio-venous thrombosis in COVID-19: A pictorial review

Abhinaya Shankar1, Baskaran Varadan1, Dillibabu Ethiraj1

  • 1Department of Radiology, Dr. Rela Institute and Medical Centre, Chennai 600044, India.

World Journal of Radiology
|February 12, 2021
PubMed

Insights

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can cause COVID-19 associated coagulopathy (CAC), leading to extrapulmonary thrombotic events. Imaging is vital for detecting these critical complications in patients with COVID-19.

Area of Science:

  • Radiology
  • Pathology
  • Infectious Diseases

Background:

  • COVID-19, caused by SARS-CoV-2, presents with systemic complications beyond respiratory issues.
  • Altered coagulation, termed COVID-19 associated coagulopathy (CAC), is a significant complication.
  • Endothelial cell infection via ACE-2 receptors is implicated in CAC pathogenesis.

Purpose of the Study:

  • To review imaging findings of extrapulmonary arterial and venous thrombotic phenomena in COVID-19 patients.
  • To highlight the role of imaging in identifying thrombotic complications not attributable to other causes.

Main Methods:

  • Review of contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) findings.
  • Focus on arterial (aorta, cerebral, mesenteric, renal, peripheral) and venous thrombotic events.
  • Pictorial review approach.

Main Results:

  • Demonstration of diverse extrapulmonary thrombotic phenomena in COVID-19 patients.
  • Identification of arterial and venous thrombosis in multiple vascular beds.
  • Imaging findings not explained by other etiologies.

Conclusions:

  • CAC contributes to severe outcomes in COVID-19, including potential sudden death.
  • Timely radiological detection of thrombotic complications is crucial for patient management.
  • Lowering the threshold for diagnostic imaging in symptomatic COVID-19 patients is recommended.

Keywords:
AortaArterialCOVID-19CoronavirusThrombusTomography

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