tetano
Editor, Senior Moderator
J Clin Transl Res
. 2021 Nov 6;7(6):797-808.
eCollection 2021 Dec 28.
A review of the presentation and outcome of left ventricular thrombus in coronavirus disease 2019 infection
Anil Mathew Philip[SUP] 1 [/SUP], Lina James George[SUP] 2 [/SUP], Kevin John John[SUP] 3 [/SUP], Anu Anna George[SUP] 4 [/SUP], Jemimah Nayar[SUP] 5 [/SUP], Kamal Kant Sahu[SUP] 6 [/SUP], Vijairam Selvaraj[SUP] 7 [/SUP], Amos Lal[SUP] 8 [/SUP], Ajay Kumar Mishra[SUP] 9 [/SUP]
Affiliations
Abstract
Background: Cardiovascular complications of the coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2), have been documented both in the acute phase and in convalescence. One such complication is the formation of the left ventricular (LV) thrombus. There is a lack of clarity regarding the incidence, risk factors, and management of this complication.
Aim: The aim of the study is to identify the clinical presentation, risk factors and outcome of COVID-19 patients with left ventricular thrombus (LVT).
Methods: A literature search was conducted to identify all case reports of COVID-19 with LVT in PubMed/Medline, Embase, Web of Science, and Google Scholar.
Results: Among the 65 patients identified, 60 had LVT, either at admission, or during the acute phase of the illness. Six patients with mild symptoms during the acute phase of viral illness had only the COVID-19 antibody test positivity at the time LV thrombus was detected. Few of the patients (23.1%) had no comorbidities. The mean age of the patients was 52.8 years, and the youngest patient was 4 years old. This suggests that LVT formation can occur in young COVID-19 patients with no co-morbid conditions. Most of the patients (69.2%) had more than one site of thrombosis. A mortality rate of 23.1% was observed in our review, and ST-elevation myocardial infarction (STEMI) was diagnosed in 33.3% of those who died.
Conclusions: A high degree of suspicion for LVT must be maintained in patients with known cardiac disease and those with new-onset arterial or venous thromboembolism, and such patients may benefit from a screening echocardiography at admission.
Relevance for patients: The patients with preexisting cardiovascular disease must take added precautions to prevent acquiring COVID-19 infection as there is a higher risk of developing LV thrombus. In patients who develop LVT in COVID-19, mortality rate is higher.
Keywords: acute coronary syndrome; coronavirus; coronavirus 2; coronavirus disease 2019; echocardiogram; left ventricular thrombus; severe acute respiratory syndrome; thromboembolism; thrombosis.
. 2021 Nov 6;7(6):797-808.
eCollection 2021 Dec 28.
A review of the presentation and outcome of left ventricular thrombus in coronavirus disease 2019 infection
Anil Mathew Philip[SUP] 1 [/SUP], Lina James George[SUP] 2 [/SUP], Kevin John John[SUP] 3 [/SUP], Anu Anna George[SUP] 4 [/SUP], Jemimah Nayar[SUP] 5 [/SUP], Kamal Kant Sahu[SUP] 6 [/SUP], Vijairam Selvaraj[SUP] 7 [/SUP], Amos Lal[SUP] 8 [/SUP], Ajay Kumar Mishra[SUP] 9 [/SUP]
Affiliations
- PMID: 34988332
- PMCID: PMC8715711
Abstract
Background: Cardiovascular complications of the coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2), have been documented both in the acute phase and in convalescence. One such complication is the formation of the left ventricular (LV) thrombus. There is a lack of clarity regarding the incidence, risk factors, and management of this complication.
Aim: The aim of the study is to identify the clinical presentation, risk factors and outcome of COVID-19 patients with left ventricular thrombus (LVT).
Methods: A literature search was conducted to identify all case reports of COVID-19 with LVT in PubMed/Medline, Embase, Web of Science, and Google Scholar.
Results: Among the 65 patients identified, 60 had LVT, either at admission, or during the acute phase of the illness. Six patients with mild symptoms during the acute phase of viral illness had only the COVID-19 antibody test positivity at the time LV thrombus was detected. Few of the patients (23.1%) had no comorbidities. The mean age of the patients was 52.8 years, and the youngest patient was 4 years old. This suggests that LVT formation can occur in young COVID-19 patients with no co-morbid conditions. Most of the patients (69.2%) had more than one site of thrombosis. A mortality rate of 23.1% was observed in our review, and ST-elevation myocardial infarction (STEMI) was diagnosed in 33.3% of those who died.
Conclusions: A high degree of suspicion for LVT must be maintained in patients with known cardiac disease and those with new-onset arterial or venous thromboembolism, and such patients may benefit from a screening echocardiography at admission.
Relevance for patients: The patients with preexisting cardiovascular disease must take added precautions to prevent acquiring COVID-19 infection as there is a higher risk of developing LV thrombus. In patients who develop LVT in COVID-19, mortality rate is higher.
Keywords: acute coronary syndrome; coronavirus; coronavirus 2; coronavirus disease 2019; echocardiogram; left ventricular thrombus; severe acute respiratory syndrome; thromboembolism; thrombosis.