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Histopathologic Evaluation of COVID-19 Patients With Peripheral Arterial Thromboembolism: Does Clot Composition Make

Nihan Yesilkaya1, Tahsin Murat Tellioglu1, Fulya Cakalagaoglu Unay2

  • 1Department of Cardiovascular Surgery, Faculty of Medicine, Izmir Katip Celebi University, Turkey.

Annals of Vascular Surgery
|April 5, 2021
PubMed

Insights

COVID-19 patients undergoing embolectomy show distinct clot compositions, with fewer red blood cells and more inflammatory cells. This suggests hyperinflammation contributes to thromboembolic events in these patients.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Pathology

Background:

  • Coronavirus disease 2019 (COVID-19) is associated with thromboembolic complications, even without typical risk factors.
  • Understanding clot composition in COVID-19 patients is crucial for managing these events.

Purpose of the Study:

  • To investigate the clinical characteristics and clot composition of patients who underwent embolectomy for COVID-19-related thromboembolism.
  • To identify differences in thromboembolic material between COVID-19 positive and negative patients.

Main Methods:

  • A retrospective cohort study of 21 patients who underwent embolectomy.
  • Analysis of demographics, clinical characteristics, laboratory values, and histopathological findings.
  • Comparison between SARS-CoV-2 positive and negative patient groups.

Main Results:

  • Eleven patients (52.3%) were SARS-CoV-2 positive; 10 (47.6%) were negative.
  • No significant differences in distribution, diagnostics, hospital stay, amputation, or mortality.
  • COVID-19 thromboembolic material had significantly lower red blood cell content (P=0.01) and higher lymphocyte (P<0.001) and leukocyte (P=0.05) counts.

Conclusions:

  • Arterial thromboembolic material in COVID-19 patients is characterized by a prominent presence of inflammatory cells.
  • Hyperinflammation combined with a prothrombotic state likely drives these thromboembolic phenomena.
Abstract

Keywords:
COVID-19EmbolectomyThromboembolism

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