Acute aortic thrombosis in a patient with SARS-CoV-2 coronavirus disease (COVID-19)

One of the rare and life-threatening conditions is acute aortic thrombosis. We have described a case of thrombosis of the aorta and iliac arteries in a patient against the background of viral pneumonia COVID-19, with newly diagnosed diabetes mellitus and arterial hypertension.

Aortic thrombosis: the forgotten source of ischemic stroke. A case report and systematic review of the literature

Ischemic stroke represents one of the most important health problems in industrialized countries, both for epidemiological and socio-economic impact. The presence of thrombi in the aorta is rare and its treatment has not been uniquely defined. Here we report the case of an 82-years-old man with aortic thrombosis and acute ischemic stroke.

Acute and Massive Aortic Thrombosis and Embolic Occlusion in a Patient with COVID-19: A Case Report

: A 73-year-old man with a history of COVID-19 infection from two weeks ago was referred to the Emergency Department with a complaint of colicky and generalized abdominal pain in addition to prior respiratory symptoms. High-resolution Computed Tomography (HRCT) displayed the typical signs of COVID-19 pneumonia. Initially, laboratory tests showed increased C-reactive protein and severe leukocytosis. Because of generalized abdominal pain, spiral abdominal and pelvic CT scans were done, which showed massive irregular and free-floating aortic thrombosis from the carina site to the Superior Mesenteric Artery (SMA) detachment, indicative of acute and life-threatening thrombosis. Filling defects were seen in the middle and distal part of the splenic artery, indicating the embolic occlusion of the splenic artery. The patient was admitted to the Intensive Care Unit (ICU), and he became a candidate for conservative treatment because of the wide extension of thrombosis. Therefore, we should pay more attention to the indirect signs of thrombosis in patients with COVID-19 infection with gastrointestinal symptoms and consider anticoagulant therapy for high-risk patients with COVID-19. The unique feature of our case was acute and extensive arterial thrombosis.

A review of aortic thrombosis in COVID-19 infection

Aim: As the novel coronavirus disease 2019 (COVID-19) pandemic impacts the global healthcare system, evolving data show increased frequency of arterial and venous thromboembolism among patients with COVID-19 infection. Aortic thrombus is a rare thrombotic event with a wide spectrum of clinical manifestations and potential catastrophic complications. This study aimed to elucidate the clinical manifestations, diagnosis and treatment dilemmas of aortic thrombus with COVID-19 infection and raise awareness among frontline medical providers. Aortic thrombosis is rare, but if not considered early in the course of COVID-19 infection, the data suggest that the diagnosis will probably not be made until potentially serious complications arise. Methods: Literature review was conducted between November 1, 2019, and November 14, 2020, on PubMed and Embase to identify publications regarding aortic thrombosis among COVID-19 cases. Results: Most of the patients were male with a median age of 67 years, and had comorbidities (most commonly hypertension, dyslipidemia and diabetes mellitus). In our study, underlying atherosclerosis, a common risk factor for aortic thrombus, was identified among 56% of the patients. Aortic thrombus was symptomatic in 62% of these patients and most commonly manifested itself as acute limb ischemia (46%), whereas 30% of cases were found incidentally during the investigation of elevated inflammatory markers or increased oxygen requirement. Treatment was individualized given the lack of established guidelines for aortic thrombus, including anticoagulation, systemic and catheter directed thrombolysis, and surgical thrombectomy. Overall mortality was found to be 30% in our study. Conclusions: Although rare, aortic thrombus has high morbidity and mortality, and can present without any symptoms or underlying aortic disease. Aortic thrombosis is rare, but if not considered early in the course of COVID-19 infection, the data suggest that the diagnosis will probably not be made until potentially serious complications arise.