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A Case of COVID-19 Induced Descending Aortic Thrombus and Splenic Infarctions

Srikrishna V Malayala1, Syed Bukhari1, Rachana Vanaparthy2

  • 1Temple University Health System, USA.

Journal of Community Hospital Internal Medicine Perspectives
|October 20, 2022
PubMed

Insights

COVID-19 can rarely cause arterial thrombosis, not just venous. This case highlights a rare instance of aortic thrombus in an unvaccinated patient, emphasizing the need for vigilance in COVID-19-related clotting disorders.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Hematology

Background:

  • Thromboembolic events, including pulmonary embolism and deep venous thrombosis, are significant causes of mortality in COVID-19.
  • COVID-19 triggers an inflammatory state that activates the coagulation cascade, leading to thrombosis.
  • While venous thrombosis is common, arterial thrombi are rare manifestations of acute COVID-19.

Observation:

  • A case report of an unvaccinated 47-year-old female presenting with fever, nausea, abdominal pain, and vomiting.
  • Imaging revealed a non-occlusive thrombus in the descending aorta, splenic infarctions, and paralytic ileus.
  • The patient had no other identifiable risk factors for hypercoagulability.

Findings:

  • The patient was diagnosed with arterial thrombosis secondary to COVID-19 infection.
  • Systemic anticoagulation was the primary treatment modality.
  • Extensive hypercoagulable workup did not reveal any underlying predisposition.

Implications:

  • This case underscores the potential for rare arterial thrombotic events in COVID-19 patients.
  • Highlights the importance of considering COVID-19 as a potential cause of unexplained arterial thrombosis, even in the absence of typical risk factors.
  • Suggests a need for heightened awareness and diagnostic consideration of thromboembolic complications in COVID-19, including arterial manifestations.

Keywords:
Aortic thrombusCovid-19IleusSplenic infarction

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