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Delayed manifestation of extensive COVID-19-associated coagulopathy in high-risk patient
  1. Purva Sharma1 and
  2. Kanishka Chakraborty2
  1. 1Medical Oncology, East Tennessee State University, Johnson City, Tennessee, USA
  2. 2Internal Medicine, East Tennessee State University, Johnson City, Tennessee, USA
  1. Correspondence to Dr Kanishka Chakraborty; chakrabk{at}etsu.edu

Abstract

COVID-19 is an infectious disease caused by the novel coronavirus. It presents as an acute respiratory illness, however, it also affects multiple other organ systems. One such unique manifestation is systemic coagulopathy involving arterial and venous systems. We present a 29-year-old woman with Hodgkin’s lymphoma, who was diagnosed with COVID-19 infection prior to initiating chemotherapy. Two months after resolution of symptoms and testing negative for COVID-19, she presented with multiple acute thromboembolic complications of the infection, including bilateral jugular venous thrombosis, right atrial clot and arterial emboli in the brain resulting in cerebrovascular injury. These were thought to be delayed manifestations of the systemic coagulopathy secondary to infection. Also, some of these thromboembolic phenomena occurred while the patient was on anticoagulation, which emphasises the extensive hyperinflammatory state caused by the virus. This case highlights the importance of thromboprophylaxis especially in high-risk patients with this infection.

  • COVID-19
  • haematology (incl blood transfusion)
  • venous thromboembolism

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Footnotes

  • Contributors PS: conception of design, writing, editing, acquisition of data, interpretation of data. KC: conception of design, acquisition of data, interpretation and analysis of data.

  • 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.

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