COVID-19 Related Arterial Coagulopathy

Gagandeep Singh; Hassan Bin Attique; Naga Vaishnavi Gadela; Khubaib Mapara; Srimathi Manickaratnam

doi:10.7759/cureus.9490

COVID-19 Related Arterial Coagulopathy

Cureus. 2020 Jul 31;12(7):e9490. doi: 10.7759/cureus.9490.

Authors

Gagandeep Singh¹, Hassan Bin Attique², Naga Vaishnavi Gadela³, Khubaib Mapara⁴, Srimathi Manickaratnam¹

Affiliations

¹ Internal Medicine, Trinity Health of New England, Hartford, USA.
² Internal Medicine, University of Connecticut School of Medicine, Farmington, USA.
³ Internal Medicine, University of Connecticut, Farmington, USA.
⁴ Vascular Surgery, Trinity Health of New England, Hartford, USA.

Abstract

Coronavirus disease of 2019 (COVID-19) is a disease caused by the novel coronavirus SARS-CoV-2, which is characterized by a multitude of clinical abnormalities, including hypercoagulability. Although thrombosis is commonly observed in sepsis, the hypercoagulable state associated with COVID-19 is much more dramatic and may not be related to either the severity of the disease or the D-dimer levels. It may be due to a prothrombotic state induced by the disease itself. We report three cases of arterial thrombosis with a significant clot burden requiring urgent medical and surgical intervention. It is now a common practice to initiate anticoagulation for deep venous thrombosis (DVT) prophylaxis based on the D-dimer level in hospitalized patients with COVID-19. However, in our clinical experience, D-dimer levels did not correlate well with the clot burden or the risk for future thrombosis.

Keywords: acute limb ischemia; arterial thrombosis; coagulopathy; coronavirus disease of 2019 (covid-19); ischemic stroke; left ventricle (lv) thrombus; venous thromboembolism (vte).

Publication types

Case Reports