Massive Arterial Cerebral Thrombosis in a 59-year old Female Patient With Severe COVID-19
Osama B Albasheer1, Haneen A Almutairi2, Fayez M Almalki3
1Family and Community Medicine, Jazan University, Jazan, SAU.
Insights
COVID-19 can cause dangerous arterial thrombosis (AT), a rare but severe complication. This case highlights a fatal instance of massive arterial cerebral thrombosis in a COVID-19 patient, emphasizing the need for vigilance.
Area of Science:
- Neurology
- Infectious Diseases
- Cardiovascular Medicine
Background:
- COVID-19 is associated with hypercoagulable states and thrombotic angiopathy.
- While venous thrombotic events are documented, arterial thrombosis (AT) in COVID-19 remains less understood.
Observation:
- A 59-year-old female with hypertension presented with COVID-19 symptoms.
- Her condition rapidly deteriorated, leading to hospitalization for severe COVID-19.
- Imaging revealed extensive arterial cerebral thrombosis.
Findings:
- The patient developed severe neurological decline despite enoxaparin prophylaxis.
- Massive arterial cerebral thrombosis was confirmed as a complication of COVID-19.
- The patient ultimately succumbed to the cerebrovascular event.
Implications:
- This case underscores the potential for severe arterial thrombosis in COVID-19 patients.
- Further research is needed to understand and manage AT in COVID-19.
- Clinicians should consider arterial thrombosis in COVID-19 patients with neurological deterioration.
Abstract:
Hypercoagulable states characterized by micro- and macro-vascular thrombotic angiopathy have been observed in COVID-19 patients. Although venous thrombotic events have been well described, data on arterial thrombosis (AT) is still insubstantial. We present a case of COVID-19 complicated with massive arterial cerebral thrombosis. Our case is a 59-year old female with history of hypertension who presented to the outpatient clinic in East Jeddah Hospital, Saudi Arabia, with sore throat, cough and arthralgia for two days. She was confirmed to be COVID-19 positive and started on azithromycin and supportive home care. Her condition worsened and she presented nine days later with drowsiness and generalized weakness. At the hospital, she was diagnosed with severe COVID-19 and was started on prophylaxis enoxaparin. She showed progressive worsening of mental function. Her CT brain showed diffuse extensive arterial cerebral thrombosis. She remained unresponsive and showed an abnormal breathing pattern on mechanical ventilation. She died on day 4 after admission.
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