Multiple Arterial Thrombosis in a 78-Year-Old Patient: Catastrophic Thrombotic Syndrome in COVID-19Novel Teaching Point
David Kenizou, MD,
Clemence Perrin, MD,
Ines Harzallah, MD,
Didier Bresson, MD,
Patrick Allimant, MD,
Mihaela Calcaianu, MD,
Bree Lawson, MD,
Béatrice Morisset, MD,
Stephane Zuily, MD, PhD,
Laurent Jacquemin, MD,
Marine Kinnel, MD,
Nicolas Girerd, MD, PhD
Affiliations
David Kenizou, MD
Cardiology Department, Mulhouse Region/South of Alsace Hospital, Hôpital E. Muller, Mulhouse, France; Corresponding author: Dr David Kenizou, Mulhouse Region/South of Alsace Hospital, Hôpital E. Muller, 20 Avenue du Dr Renè Laennec, 68100 Mulhouse, France. Tel.: 03 89 64 70 95.
Clemence Perrin, MD
Cardiology Department, Mulhouse Region/South of Alsace Hospital, Hôpital E. Muller, Mulhouse, France
Ines Harzallah, MD
Hematology Department, Mulhouse Region/South of Alsace Hospital, Hôpital E. Muller, Mulhouse, France
Didier Bresson, MD
Cardiology Department, Mulhouse Region/South of Alsace Hospital, Hôpital E. Muller, Mulhouse, France
Patrick Allimant, MD
Vascular Surgery Department, Mulhouse Region/South of Alsace Hospital, Hôpital E. Muller, Mulhouse, France
Mihaela Calcaianu, MD
Cardiology Department, Mulhouse Region/South of Alsace Hospital, Hôpital E. Muller, Mulhouse, France
Bree Lawson, MD
Cardiology Department, Mulhouse Region/South of Alsace Hospital, Hôpital E. Muller, Mulhouse, France
Béatrice Morisset, MD
Cardiology Department, Mulhouse Region/South of Alsace Hospital, Hôpital E. Muller, Mulhouse, France
Stephane Zuily, MD, PhD
Lorraine University, Inserm, DCAC, Nancy, France
Laurent Jacquemin, MD
Cardiology Department, Mulhouse Region/South of Alsace Hospital, Hôpital E. Muller, Mulhouse, France
Marine Kinnel, MD
Cardiology Department, Mulhouse Region/South of Alsace Hospital, Hôpital E. Muller, Mulhouse, France
Nicolas Girerd, MD, PhD
CHRU-Nancy, Regional Competence Center For Marfan Syndrome, Vascular Medicine Division, Nancy, France
We describe a patient with coronavirus disease 2019 (COVID-19) and multiple concomitant thromboses occurring on the 9th day of hospital stay. Thromboses were found in distinct zones of the aorta, as well as in the renal, humeral, and pulmonary arteries. The extensive biological workup performed following this catastrophic thrombotic syndrome found no evidence for underlying prothrombotic disease. In light of current evidence regarding endothelium abnormalities related to COVID-19, this extreme case of catastrophic thrombotic syndrome suggests that COVID-19 can induce severe arterial thrombosis following intense endothelial activation. Résumé: Nous décrivons le cas d’un patient atteint de la maladie à coronavirus 2019 (COVID-19) et présentant de multiples thromboses concomitantes survenant au 9e jour d'hospitalisation. Les thromboses ont été identifiées dans des zones distinctes de l'aorte, ainsi que dans les artères rénales, humérales et pulmonaires. Un examen biologique approfondi effectué à la suite de ce syndrome thrombotique catastrophique n'a révélé aucun signe de maladie prothrombotique sous-jacente. À la lumière de ces éléments concernant les anomalies de l'endothélium liées à la COVID-19, ce cas extrême de syndrome thrombotique catastrophique suggère que la COVID-19 peut induire une thrombose artérielle sévère suite à une activation endothéliale intense.
