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Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Eur+Heart+J+Case+Rep 2020 ; 4 (6): 1-7 Nephropedia Template TP
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Corona Virus Disease 2019 in situ arterial and venous thrombosis in critically ill patients: a case series #MMPMID33442596
Castro-Verdes M; Gkouma A; Wort J; Ridge C; Mirsadraee S; Padley S; Sheikh A; Singh S
Eur Heart J Case Rep 2020[Dec]; 4 (6): 1-7 PMID33442596show ga
BACKGROUND: Corona Virus Disease 2019 (COVID-19) pneumonitis associated with severe respiratory failure carries a high mortality. Coagulopathy has emerged as a significant contributor to thrombotic complications. CASE SUMMARY: We describe two cases of severe COVID-19 pneumonitis refractory to conventional mechanical ventilation and proning position, transferred to our specialist centre for cardiorespiratory failure. Cross-sectional imaging demonstrated concurrent venous and aortic thrombosis with end-organ ischaemic changes. One patient received thrombolysis with a partial response. This could not be offered to the other patient due to a recent haemorrhagic event. Both patients died of multi-organ failure in the hospital. DISCUSSION: Concurrent aortic and venous thromboses are rare. This finding in COVID-19 cases, who were both critically ill patients, likely reflects the strongly thrombogenic nature of this illness which ultimately contributed to poor outcomes. The absence of deep vein thrombosis or a potential systemic source of embolism suggests in situ thrombosis. Further, the management of anticoagulation and thrombolysis is challenging in patients where an attendant bleeding risk exists.