Case Reports Open access

Simultaneous arterial and venous thromboembolic events associated with COVID-19. A case report

Authors

Published
28 June 2021
Section
Case Reports
DOI
10.4081/ecj.2021.9718

Abstract

Infections with COVID-19 can induce thrombophilia and increase the risk of thrombotic events. We describe a case of a 64- years-old male who presents with intermediate-risk pulmonary embolism and brachial artery thrombosis secondary to an undiagnosed patent foramen ovale and COVID-19 infection. The patient was successfully treated with thrombolysis and heparin infusions and was discharged home with long-term anticoagulation. Managing patients with multiple pathologies occurring concurrently requires effective inter-speciality working in order to take a holistic approach to managing the patient opposed to managing the conditions in isolation. This case report highlights how clinical guidelines can support decision making of the individual pathologies but working as a team will enable the best care.

Keywords

References

  1. Petruzzelli S, Palla A, Pieraccini F, et al. Routine electrocardiography in screening for pulmonary embolism. Respiration 1986;50:233-43. DOI: https://doi.org/10.1159/000194933
  2. Zhang L, Yan X, Fan Q, et al. D‐dimer levels on admission to predict in‐hospital mortality in patients with Covid‐19. J Thromb Haemost 2020;18:1324-9. DOI: https://doi.org/10.1111/jth.14859
  3. Leonard-Lorant I, Delabranche X, Severac F, et al. Acute pulmonary embolism in COVID-19 patients on CT angiography and relationship to D-dimer levels. Radiology 2020:201561. DOI: https://doi.org/10.1148/radiol.2020201561
  4. BTS Guidance on venous thromboembolic disease in patients with COVID-19. Updated 4 May 2020.
  5. Aujesky D, Obrosky DS, Stone RA, et al. Derivation and validation of a prognostic model for pulmonary embolism. Am J Resp Critical Care Med 2005;172:1041-6. DOI: https://doi.org/10.1164/rccm.200506-862OC
  6. Klok FA, Kruip MJ, Van Der Meer NJ, et al. Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: an updated analysis. Thromb Res 2020;191:148-50. DOI: https://doi.org/10.1016/j.thromres.2020.04.041
  7. Wise J. Covid-19 and thrombosis: what do we know about the risks and treatment? BMJ 2020;369:m2058. DOI: https://doi.org/10.1136/bmj.m2058
  8. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020;18:844-7. DOI: https://doi.org/10.1111/jth.14768
  9. Iba T, Di Nisio M, Levy JH, et al. New criteria for sepsis-induced coagulopathy (SIC) following the revised sepsis definition: a retrospective analysis of a nationwide survey. BMJ Open 2017;7:e017046. DOI: https://doi.org/10.1136/bmjopen-2017-017046
  10. Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). Eur Heart J 2020;41:543-603. DOI: https://doi.org/10.1093/eurheartj/ehz405
  11. Meyer G, Vicaut E, Danays T, et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med 2014;370:1402-11. DOI: https://doi.org/10.1056/NEJMoa1302097

Metrics

Citations and online attention from Dimensions, Altmetric and PlumX.

PlumX Metrics

License

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.