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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Case report
COVID-19 associated with extensive pulmonary arterial, intracardiac and peripheral arterial thrombosis
  1. Katie Ferguson1,
  2. Nathaniel Quail1,2,
  3. Peter Kewin1 and
  4. Kevin G Blyth1,3
  1. 1Department of Respiratory Medicine, Queen Elizabeth University Hospital, Glasgow, UK
  2. 2College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
  3. 3Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
  1. Correspondence to Professor Kevin G Blyth; kevin.blyth{at}glasgow.ac.uk

Abstract

We describe a patient with COVID-19 who developed simultaneous pulmonary, intracardiac and peripheral arterial thrombosis. A 58-year-old man, without major comorbidity, was admitted with a 14-day history of breathlessness. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection was confirmed by laboratory testing. Initial imaging revealed COVID-19 pneumonia but no pulmonary thromboembolism (PTE) on CT pulmonary angiography (CTPA). The patient subsequently developed respiratory failure and left foot ischaemia associated with a rising D-dimer. Repeat CTPA and lower limb CT angiography revealed simultaneous bilateral PTE, biventricular cardiac thrombi and bilateral lower limb arterial occlusions. This case highlights a broad range of vascular sequalae associated with COVID-19 and the fact that these can occur despite a combination of prophylactic and treatment dose anticoagulation.

  • venous thromboembolism
  • pneumonia (infectious disease)

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2020-237460

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    Footnotes

    • Twitter @DrNatQuail, @kevingblyth

    • Contributors NQ and KF contributed equally to writing this paper. KGB contributed to intellectual content of the case report and had overall supervision of the writing. PK provided support in writing the case and looked after the patient in hospital.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.