Hyperacute multi-organ thromboembolic storm in COVID-19: a case report.
J Thromb Thrombolysis
; 51(1): 25-28, 2021 Jan.
Article
in English
| MEDLINE | ID: covidwho-548286
ABSTRACT
Acute viral pneumonia, hypoxemic respiratory failure and severe inflammatory response are hallmarks of severe coronavirus disease 2019 (COVID-19). The COVID-19-associated inflammatory state may further lead to symptomatic thromboembolic complications despite prophylaxis. We report a 66-year-old female patient with post-mortem diagnosis of COVID-19 who presented progressive livedo racemosa, acute renal failure and myocardial injury, as well as an absence of respiratory symptoms. Transthoracic echocardiography showed severe spontaneous echo contrast in the right cardiac chambers and right-sided cardiac overload presumed to result from pulmonary microvascular thrombosis or embolism. D-dimer levels were increased. The patient developed an acute ischemic stroke and died 2 days following presentation despite therapeutic anticoagulation. Her predominantly thromboembolic presentation supports the concept of coronavirus infection of endothelial cells and hypercoagulability, or COVID-19 endotheliitis. The case we report highlights that COVID-19-associated hyperacute multi-organ thromboembolic storm may precede or present disproportionately to respiratory involvement.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Thromboembolism
/
Echocardiography
/
Thrombophilia
/
Ischemic Stroke
/
SARS-CoV-2
/
COVID-19
/
Anticoagulants
/
Cardiomyopathies
Type of study:
Case report
/
Diagnostic study
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Language:
English
Journal:
J Thromb Thrombolysis
Journal subject:
Vascular Diseases
Year:
2021
Document Type:
Article
Affiliation country:
S11239-020-02173-w
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