CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 2, May/June 2023 114 AFRICA Case Reports SARS-CoV-2 infection-associated thoraco-abdomino-iliac thrombosis in a patient without cardiac and systemic co-morbidity Ferhat Borulu, Bilgehan Erkut, Yahya Unlu Abstract Acute pulmonary damage and vascular coagulopathy occur frequently in patients with severe acute respiratory syndrome coronavirus 2 infection in relation to coronavirus disease (COVID-19). The inflammatory process accompanying the infection and excessive coagulation state is one of the most important causes of patient death. The COVID-19 pandemic remains a major challenge for healthcare systems and millions of patients worldwide. In this report, we present a complicated case of COVID-19 associated with lung disease and aortic thrombosis. Keywords: SARS-CoV-2 infection, COVID-19, aortic thrombosis, pulmonary peripheral ground-glass opacification, coronary virus Submitted 20/2/21; accepted 28/5/22 Cardiovasc J Afr 2023; 34: 114–116 www.cvja.co.za DOI: 10.5830/CVJA-2022-025 Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), the cause of coronavirus disease (COVID-19), emerged in Wuhan and became a worldwide pandemic, causing high infection and mortality rates.1,2 One of the most important features of a poor prognosis in patients with COVID-19 is the development of vascular coagulopathy.1,3 To date, numerous publications and large numbers of COVID-19 cases have been reported worldwide. Whereas most of these cases are patients with pulmonary embolism and pulmonary disease, fewer cases of arterial thrombosis have been reported. Case report A 51-year-old male patient, who did not have any previous cardiac or lung problems, was admitted to our hospital with coldness and cyanotic discolouration in the lower extremities, back pain and shortness of breath. The patient, who was evaluated in the clinic for chest diseases and cardiovascular vascular surgery, had decreased bilateral breathing sounds. On lower extremity pulsation examination, his pulses were not palpable, his feet were cold and purple, and he had loss of sensation. Features of ischaemia were prominent in the lower extremity. During history taking, the patient was found to have attended a domestic funeral a week before. Considering that he had had no co-morbid condition before, the chest and back pains and thrombotic condition were suspected to be due to COVID19 infection. Electrocardiography revealed sinus rhythm with no ischaemic changes. The results of laboratory studies demonstrated mild leukocytosis (21.2 × 103 cells/ml), thrombocytosis (811.2 × 103 cells/l) and lymphopaenia (0.67 × 103 cells/ml). The patient’s D-dimer and fibrinogen values were extremely elevated at 32.112 and 9.865 mg/dl, respectively. His serum procalcitonin and C-reactive protein values were also significantly increased. Chest radiology revealed diffuse bilateral consolidation (Fig. 1), and thoracic computed tomography confirmed COVIDDepartment of Cardiovascular Surgery, Medical Faculty, Atatürk University, Erzurum, Turkey Ferhat Borulu, MD Bilgehan Erkut, MD, bilgehanerkut@yahoo.com Yahya Unlu, MD Fig. 1. Chest roentgenogram demonstrates an infiltrative condition associated with COVID-19 infection in the lung tissue (red arrows).
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