ABSTRACT
A high incidence of thromboembolic events and coagulation parameter abnormalities are seen in cases of coronavirus disease 2019 (COVID-19). Both venous and arterial thrombosis, including arterial thrombosis in unusual sites, have been reported in COVID patients in recent literature. Herein, we report a case of a 67-year-old female patient with non-critical COVID-19 disease with an incidental finding of an asymptomatic splenic infarct. In the absence of a cardio-embolic source, we believe this was an arterial thromboembolic event in the splenic circulation. The duration and modality of anticoagulation of inpatient and ambulatory COVID patients remains a dynamic discussion. Our case adds the evidence of a clinically silent arterial thrombotic event in a non-critical COVID-19 patient which further emphasizes the need to address the strategies for diagnosis and management of thrombo-embolism to prevent potentially fatal complications.
ABSTRACT
COVID-19 disease is a viral illness that predominantly causes pneumonia and severe acute respiratory distress syndrome. The endothelial injury and hypercoagulability secondary to the inflammatory response predisposes severely ill patients to venous thromboembolism. The exact mechanism of hypercoagulability is still under investigation, but it is known to be associated with poor prognosis. The most common thrombotic complication reported among these patients is pulmonary embolism. To our knowledge, gonadal vein thrombosis is an uncommon phenomenon that has not been reported in the setting of COVID-19-associated coagulopathy. We report an unusual case of ovarian vein thrombosis and pulmonary embolism associated with COVID-19 presenting with abdominal pain. To our knowledge, this is the first reported case of COVID-19 with absent respiratory symptoms and presentation with venous thrombosis in an unusual location.