Delayed Diagnosis of Paget-Schroetter Syndrome in a Patient with COVID-19

Paget-Schroetter Syndrome (PSS), a subtype of thoracic outlet syndrome, is a rare condition defined as thrombosis of the axillosubclavian vein secondary to anatomical abnormalities or repetitive injury to vessel endothelium from exertion. In the setting of the COVID-19 pandemic, venous thrombosis in COVID-positive patients may be attributed to the well-described hypercoagulability associated with the viral syndrome, increasing the rate of misdiagnosis of PSS and delaying definitive treatment. We report a case of PSS in a 19-year-old male who presented to multiple health care providers with an upper extremity thrombus and was found to be SARS-CoV-2 positive on hospitalization. In his case, his COVID status likely contributed to a delay in diagnosis of Paget- Schroetter syndrome, with the patient missing the window for the standard treatment protocol.