Volume 5, 2021

Covid 19


Mitko Mitev

Pages: 28-31

DOI: 10.21175/RadProc.2021.05

Introduction . Venous and arterial thromboembolism is associated with COVID-19, but there are few studies of lower limb ischemia as a later complication of infection. The study presents identified early and late complications caused by COVID-19, with the presence of multiple thromboses in the aorta and peripheral vessels. Materials and methods. A patient is an 80-year-old man hospitalized with COVID-19 (SARS-CoV-2). The study was conducted in 2021. MDCT Siemens Definition AS was used. A computed tomography angiography was made with Omnipaque, 100 ml. The data was processed with Syngo.via workstation and VB40B_NF02 software version. Results. After computed tomography angiography, changes were found in the lungs, central and peripheral vessels. Bilateral interstitial pneumonia was diagnosed. A parietal thrombus was identified in the aortic arch area and acute thrombosis on the left side of the common iliac artery and the right side of the superficial femoral artery as an acute later complication of the infection. The patient was sent for emergency surgery to remove the found blood clots in the lower limbs. Conclusion. The application of the correct diagnostic algorithm in this clinical case with the application of CT scan with contrast helped to quickly identify early complications and to avoid more severe and later changes both in the vessels and in other organs and systems.
  1. J. Helms et al., “High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study,” Intensive Care Med., vol. 46, no. 6, pp. 1089–1098, May 2020.
    DOI: https://doi.org/10.1007/s00134-020-06062-x
    PMid: 32367170
  2. P. Vulliamy, S. Jacob, R.A. Davenport, “Acute aorto-iliac and mesenteric arterial thromboses as presenting features of COVID-19,” Br. J. Haem., vol. 189, no. 6, pp. 1053–1054, May 2020.
    DOI: https://doi.org/10.1111/bjh.16760
    PMid: 32353183
  3. P. Kaur et al., “Acute upper limb ischemia in a patient with COVID-19,” Hematol. Oncol. Stem. Cell. Ther., vol. 14, no. 6, pp. 1658–3876, May 2020.
    DOI: https://doi.org/10.1016/j.hemonc.2020.05.001
    PMid: 32405288
  4. O. de Barry et al., “Arterial and venous abdominal thrombosis in a 79-year-old woman with COVID-19 pneumonia,” Radiol. Case Rep., vol. 15, no. 7, pp. 1054–1057, Apr. 2020.
    DOI: https://doi.org/10.1016/j.radcr.2020.04.055
    PMid: 32351657
  5. C. Schweblin, A.L. Hachulla, M. Roffi, F. Glauser, “Delayed manifestation of COVID-19 presenting as lower extremity multilevel arterial thrombosis: a case report,” European Heart Journal – Case Reports, vol. 4, no. 6, pp. 1–4, Dec. 2020.
    DOI: https://doi.org/10.1093/ehjcr/ytaa371
    PMid: 33437919
  6. J.F. Llitjos et al., “High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients,” J. Thromb. Haemost., vol. 18, no. 7, pp. 743–1746, May 2020.
    DOI: https://doi.org/10.1111/jth.14869
    PMid: 32320517
  7. D. Wichmann et al., “Autopsy findings and venous thromboembolism in patients with COVID-19: a prospective cohort study,” Ann. Intern. Med., vol. 173, no. 4, pp. 268–277, Aug. 2020.
    DOI: https://doi.org/10.7326/M20-2003
    PMid: 32374815
  8. P. Fontana et al., “Venous thromboembolism in COVID-19: systematic review of reported risks and current guidelines,” Swiss. Med. Wkly., vol. 150, article no. w20301, Jun. 2020.
    DOI: https://doi.org/10.4414/smw.2020.20301
    PMid: 32640479
  9. V.O. Costa et al., “Acute arterial occlusion of the lower limb as the main clinicalmanifestation in a patient with Covid-19 – Case Report,” International Journal of Surgery Case Reports, vol. 77, pp. 454–458, Nov. 2020.
    DOI: https://doi.org/10.1016/j.ijscr.2020.11.046
    PMid: 33200062
  10. I. Cheruiyot et al., “Arterial Thrombosis in Coronavirus Disease 2019 Patients: A Rapid Systematic Review,” Ann. Vasc. Surg., vol. 70, pp. 273–281, Aug. 2020.
    DOI: https://doi.org/10.1016/j.avsg.2020.08.087
    PMid: 32866574
  11. I.A. Goldman, K. Ye, M.H. Scheinfeld, “Lower-extremity Arterial Thrombosis Associated with COVID-19 Is Characterized by Greater Thrombus Burden and Increased Rate of Amputation and Death,” Radiol., vol. 297, no. 2, pp. E263–E269, Jul. 2020.
    DOI: https://doi.org/10.1148/radiol.2020202348
    PMid: 32673190
Mitko Mitev, "Multiple thromboses as late complications in a patient with pneumonia caused by covid-19 infection", RAD Conf. Proc, vol. 5, 2021, pp. 28-31, http://doi.org/10.21175/RadProc.2021.05