Concomitant renal and splenic infarctions in a COVID-19-patient with a catastrophic thrombotic syndrome

Abstract

Since the outbreak of the COVID-19 pandemic, thrombotic events have been accurately described in patients infected by the SARS-CoV-2, especially venous thromboembolism. However, the mystery of arterial thrombosis is still unclear. Here, we report the case of a 59-year-old man with diabetes mellitus, admitted for COVID-19-pneumonia complicated by pulmonary embolism, a thrombus in the aortic isthmus, the descending thoracic aorta associated with splenic and left renal infarctions, and an acute right limb ischemia. The etiological assessment of this catastrophic thrombotic syndrome showed no evidence for preexisting inherited or acquired thrombophilia. Our case emphasizes the hypercoagulability state in COVID-19-patient leading to both arterial and venous thromboembolisms and the need to establish adequate strategies for the diagnosis and management of thrombo-embolisms to prevent these potentially fatal complications.

Keywords

• COVID-19
• Hypercoagulability
• Arterial thrombosis
• Catastrophic thrombotic syndrome
• Renal infarction
• Splenic infarction