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Case report
Multiorgan thrombosis as a complication of COVID-19 pneumonia
  1. Etienne Ceci Bonello1,
  2. Ramon Casha2,
  3. Thelma Xerri2,
  4. John Bonello3,
  5. Claudia Fsadni2 and
  6. Charles Mallia Azzopardi2
  1. 1General Medicine, Mater Dei Hospital, Msida, Malta
  2. 2Infectious Diseases and General Medicine, Mater Dei Hospital, Msida, Malta
  3. 3Cardiology, Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Etienne Ceci Bonello; etienne.ceci{at}gov.mt

Abstract

A 47-year-old man, positive for SARS-CoV-2, was diagnosed with acute coronary syndrome (ACS) complicated by myocarditis on a background of COVID-19 pneumonia. He was medically treated for ACS; however, 3 days into his admission, the patient developed neurological complications confirmed on MRI of the brain. MRI showed established infarcts involving a large part of the left temporal lobe and right occipital lobe, with minor foci of micro-haemorrhagic transformation in the left temporal lobe. A left ventricular mural thrombus was then confirmed on echocardiogram, and this was attributed as the cause of his neurological infarct. Further infarctions in the kidneys and spleen, and thrombi in the superior mesenteric and left femoral artery were also identified on imaging of the abdomen. The left ventricular mural thrombus was removed surgically via a midline sternotomy incision under general anaesthesia. Surgery was successful and the patient was discharged to a rehabilitation centre.

  • COVID-19
  • cardiovascular medicine
  • neurology
  • cardiothoracic surgery

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-2021-243953

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    Footnotes

    • Contributors ECB—acquisition of data, planning, manuscript editing and discussion. RC—imaging preparation, planning, manuscript editing and discussion. TX—manuscript editing and discussion. JB—imaging preparation and manuscript revision. CF—manuscript revision and guarantor of case integrity. CMA—manuscript revision and guarantor of case integrity.

    • 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.