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Eur Heart J Case Rep . Clinical spectrum of ischaemic arterial diseases associated with COVID-19: a series of four illustrative cases

tetano

Editor, Senior Moderator
Eur Heart J Case Rep


. 2020 Dec 25;5(1):ytaa488.
doi: 10.1093/ehjcr/ytaa488. eCollection 2021 Jan.
Clinical spectrum of ischaemic arterial diseases associated with COVID-19: a series of four illustrative cases


Henri Guillet[SUP] 1 2 3 [/SUP], Romain Gallet[SUP] 1 4 [/SUP], Vincent Pham[SUP] 4 [/SUP], Thomas D'Humi?res[SUP] 1 5 [/SUP], Raphaelle Huguet[SUP] 1 4 [/SUP], Pascal Lim[SUP] 1 4 [/SUP], Marc Michel[SUP] 1 6 [/SUP], Mehdi Khellaf[SUP] 1 2 7 [/SUP]



Affiliations

Abstract

Background: Severe coronavirus-induced disease 2019 (COVID-19) leads to acute respiratory distress syndrome with an increased risk of venous thrombo-embolic events. To a much lesser extent, arterial thrombo-embolic events have also been reported in this setting.
Case summary: Here, we describe four different cases of COVID-19 infection with ischaemic arterial events, such as a myocardial infarction with high thrombus load, ischaemic stroke on spontaneous thrombosis of the aortic valve, floating thrombus with mesenteric, splenic and renal infarction, and acute limb ischaemia.
Discussion: Cardiovascular risk factors such as hypertension, obesity, and diabetes are comorbidities most frequently found in patients with a severe COVID-19 infection and are associated with a higher death rate. Our goal is to provide an overview of the clinical spectrum of ischaemic arterial events that may either reveal or complicate COVID-19. Several suspected pathophysiological mechanisms could explain the association between cardiovascular events and COVID-19 (role of systemic inflammatory response syndrome, endothelial dysfunction, activation of coagulation cascade leading to a hypercoagulability state, virus-induced secondary antiphospholipid syndrome). We need additional studies of larger size, to estimate the incidence of these arterial events and to assess the efficacy of anticoagulation therapy.

Keywords: Acute coronary syndrome; Acute limb ischaemia; COVID-19; Case series; Stroke.
 
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