tetano
Editor, Senior Moderator
Thromb J
. 2021 Aug 18;19(1):57.
doi: 10.1186/s12959-021-00304-8.
Multiple simultaneous embolic cerebral infarctions 11 months after COVID-19
Rajiv Advani[SUP] 1 2 [/SUP], Torbjørn Austveg Strømsnes[SUP] 3 4 [/SUP], Espen Stjernstrøm[SUP] 5 [/SUP], Sebastian T Lugg[SUP] 6 [/SUP]
Affiliations
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.
Keywords: Anticoagulation; COVID-19; Coagulopathy; Pulmonary Embolus; Stroke; Thrombolysis.
. 2021 Aug 18;19(1):57.
doi: 10.1186/s12959-021-00304-8.
Multiple simultaneous embolic cerebral infarctions 11 months after COVID-19
Rajiv Advani[SUP] 1 2 [/SUP], Torbjørn Austveg Strømsnes[SUP] 3 4 [/SUP], Espen Stjernstrøm[SUP] 5 [/SUP], Sebastian T Lugg[SUP] 6 [/SUP]
Affiliations
- PMID: 34407847
- DOI: 10.1186/s12959-021-00304-8
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.
Keywords: Anticoagulation; COVID-19; Coagulopathy; Pulmonary Embolus; Stroke; Thrombolysis.