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Multiple simultaneous embolic cerebral infarctions 11 months after COVID-19.
Advani, Rajiv; Strømsnes, Torbjørn Austveg; Stjernstrøm, Espen; Lugg, Sebastian T.
  • Advani R; Stroke Unit, Department of Neurology, Oslo University Hospital, Oslo, Norway.
  • Strømsnes TA; Neuroscience Research Group, Stavanger University Hospital, Stavanger, Norway.
  • Stjernstrøm E; Stroke Unit, Department of Neurology, Oslo University Hospital, Oslo, Norway. t.a.austveg@gmail.com.
  • Lugg ST; Department of Clinical Medicine, University of Bergen, Bergen, Norway. t.a.austveg@gmail.com.
Thromb J ; 19(1): 57, 2021 Aug 18.
Article in English | MEDLINE | ID: covidwho-1365359
ABSTRACT

BACKGROUND:

The coronavirus disease (COVID-19) pandemic has led to an unprecedented worldwide burden of disease. However, little is known of the longer-term implications and consequences of COVID-19. One of these may be a COVID-19 associated coagulopathy that can present as a venous thromboembolism (VTE) and further, as multiple paradoxical cerebral emboli. CASE PRESENTATION A 51 year old man presented to the emergency department with multiple simultaneous embolic cerebral infarctions 11 months after mild COVID-19. In the subacute phase of the COVID-19 illness the patient developed increasing shortness of breath and was found to have an elevated D-dimer and multiple bilateral segmental pulmonary emboli. He was subsequently treated with 3 months of anticoagulation for a provoked VTE. The patient then presented 11 months after the initial COVID-19 diagnosis with multiple simultaneous cerebral infarctions where no traditional underlying stroke etiology was determined. A patent foramen ovale (PFO) and an elevated D-dimer were found suggesting a paradoxical thromboembolic event due to an underlying coagulopathy.

CONCLUSIONS:

This case report highlights the one of the potentially more serious complications of long-term COVID-19 where VTE due to a persistent coagulopathy is seen almost a year after the initial illness. Due to the highly prevalent nature of PFO in the general population, VTE due to COVID-19 associated coagulopathy could lead to ischemic stroke. This case report highlights the possibility for an underlying COVID-19 associated coagulopathy which may persist for many months and beyond the initial illness.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study Topics: Long Covid Language: English Journal: Thromb J Year: 2021 Document Type: Article Affiliation country: S12959-021-00304-8

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study Topics: Long Covid Language: English Journal: Thromb J Year: 2021 Document Type: Article Affiliation country: S12959-021-00304-8