COVID-19 associated with extensive pulmonary arterial, intracardiac and peripheral arterial thrombosis

Ferguson, K., Quail, N., Kewin, P. and Blyth, K. G. (2020) COVID-19 associated with extensive pulmonary arterial, intracardiac and peripheral arterial thrombosis. BMJ Case Reports, 13(8), e237460. (doi: 10.1136/bcr-2020-237460) (PMID:32747597) (PMCID:PMC7401579)

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Abstract

We describe a patient with COVID-19 who developed simultaneous pulmonary, intracardiac and peripheral arterial thrombosis. A 58-year-old man, without major comorbidity, was admitted with a 14-day history of breathlessness. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection was confirmed by laboratory testing. Initial imaging revealed COVID-19 pneumonia but no pulmonary thromboembolism (PTE) on CT pulmonary angiography (CTPA). The patient subsequently developed respiratory failure and left foot ischaemia associated with a rising D-dimer. Repeat CTPA and lower limb CT angiography revealed simultaneous bilateral PTE, biventricular cardiac thrombi and bilateral lower limb arterial occlusions. This case highlights a broad range of vascular sequalae associated with COVID-19 and the fact that these can occur despite a combination of prophylactic and treatment dose anticoagulation.

Item Type:Articles
Keywords:Pneumonia (infectious disease), venous thromboembolism.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Ferguson, Katie and Kewin, Dr Peter and Blyth, Professor Kevin and Quail, Dr Nat
Authors: Ferguson, K., Quail, N., Kewin, P., and Blyth, K. G.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:BMJ Case Reports
Publisher:BMJ Publishing Group
ISSN:1757-790X
ISSN (Online):1757-790X
Published Online:03 August 2020

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