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Persistent hypercoagulability and acute limb ischemia post COVID-19

Natalia Penaloza1, Emmanuel C Ebirim1, Annie Cherner2

  • 1John Sealy School of Medicine, University of Texas Medical Branch Galveston, Galveston, TX.

Journal of Vascular Surgery Cases and Innovative Techniques
|December 8, 2025
PubMed

Research indicates that COVID-19 induces endotheliitis, hypercoagulation, and hypofibrinolysis owing to virus-induced endothelial dysfunction. We present a case of a 34-year-old man with acute limb ischemia 4 days after COVID-19 diagnosis. Arterial duplex ultrasound examination revealed acute thrombosis of the popliteal artery and systemic anticoagulation was started. Despite multiple successful embolectomies and aggressive anticoagulant therapy, rethrombosis occurred, requiring bypass surgery approximately 1 year later. This case highlights the prolonged hypercoagulability post COVID-19 infection and the need for ongoing monitoring and tailored thromboprophylaxis to manage complications, especially with the evolving understanding of COVID-19-related hypercoagulability.

Keywords:
COVID-19Case reportHypercoagulabilityThrombosis

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