Multiple simultaneous embolic cerebral infarctions 11 months after COVID-19
Abstract Background The coronavirus disease (COVID-19) pandemic has led to an unprecedented worldwide burden of disease. However, little is known of the longer-term implications and consequences of COVID-19. One of these may be a COVID-19 associated coagulopathy that can present as a venous thromboe...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | Thrombosis Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12959-021-00304-8 |
| _version_ | 1819137902401028096 |
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| author | Rajiv Advani Torbjørn Austveg Strømsnes Espen Stjernstrøm Sebastian T. Lugg |
| author_facet | Rajiv Advani Torbjørn Austveg Strømsnes Espen Stjernstrøm Sebastian T. Lugg |
| author_sort | Rajiv Advani |
| collection | DOAJ |
| description | Abstract Background The coronavirus disease (COVID-19) pandemic has led to an unprecedented worldwide burden of disease. However, little is known of the longer-term implications and consequences of COVID-19. One of these may be a COVID-19 associated coagulopathy that can present as a venous thromboembolism (VTE) and further, as multiple paradoxical cerebral emboli. Case presentation A 51 year old man presented to the emergency department with multiple simultaneous embolic cerebral infarctions 11 months after mild COVID-19. In the subacute phase of the COVID-19 illness the patient developed increasing shortness of breath and was found to have an elevated D-dimer and multiple bilateral segmental pulmonary emboli. He was subsequently treated with 3 months of anticoagulation for a provoked VTE. The patient then presented 11 months after the initial COVID-19 diagnosis with multiple simultaneous cerebral infarctions where no traditional underlying stroke etiology was determined. A patent foramen ovale (PFO) and an elevated D-dimer were found suggesting a paradoxical thromboembolic event due to an underlying coagulopathy. Conclusions This case report highlights the one of the potentially more serious complications of long-term COVID-19 where VTE due to a persistent coagulopathy is seen almost a year after the initial illness. Due to the highly prevalent nature of PFO in the general population, VTE due to COVID-19 associated coagulopathy could lead to ischemic stroke. This case report highlights the possibility for an underlying COVID-19 associated coagulopathy which may persist for many months and beyond the initial illness. |
| first_indexed | 2024-12-22T10:58:15Z |
| format | Article |
| id | doaj.art-25ef644f92c249febc912584badc5a57 |
| institution | Directory Open Access Journal |
| issn | 1477-9560 |
| language | English |
| last_indexed | 2024-12-22T10:58:15Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj.art-25ef644f92c249febc912584badc5a572022-12-21T18:28:34ZengBMCThrombosis Journal1477-95602021-08-011911610.1186/s12959-021-00304-8Multiple simultaneous embolic cerebral infarctions 11 months after COVID-19Rajiv Advani0Torbjørn Austveg Strømsnes1Espen Stjernstrøm2Sebastian T. Lugg3Stroke Unit, Department of Neurology, Oslo University HospitalStroke Unit, Department of Neurology, Oslo University HospitalDepartment of Radiology, Oslo University HospitalInstitute of Inflammation and Ageing, University of BirminghamAbstract Background The coronavirus disease (COVID-19) pandemic has led to an unprecedented worldwide burden of disease. However, little is known of the longer-term implications and consequences of COVID-19. One of these may be a COVID-19 associated coagulopathy that can present as a venous thromboembolism (VTE) and further, as multiple paradoxical cerebral emboli. Case presentation A 51 year old man presented to the emergency department with multiple simultaneous embolic cerebral infarctions 11 months after mild COVID-19. In the subacute phase of the COVID-19 illness the patient developed increasing shortness of breath and was found to have an elevated D-dimer and multiple bilateral segmental pulmonary emboli. He was subsequently treated with 3 months of anticoagulation for a provoked VTE. The patient then presented 11 months after the initial COVID-19 diagnosis with multiple simultaneous cerebral infarctions where no traditional underlying stroke etiology was determined. A patent foramen ovale (PFO) and an elevated D-dimer were found suggesting a paradoxical thromboembolic event due to an underlying coagulopathy. Conclusions This case report highlights the one of the potentially more serious complications of long-term COVID-19 where VTE due to a persistent coagulopathy is seen almost a year after the initial illness. Due to the highly prevalent nature of PFO in the general population, VTE due to COVID-19 associated coagulopathy could lead to ischemic stroke. This case report highlights the possibility for an underlying COVID-19 associated coagulopathy which may persist for many months and beyond the initial illness.https://doi.org/10.1186/s12959-021-00304-8COVID-19Pulmonary EmbolusStrokeThrombolysisAnticoagulationCoagulopathy |
| spellingShingle | Rajiv Advani Torbjørn Austveg Strømsnes Espen Stjernstrøm Sebastian T. Lugg Multiple simultaneous embolic cerebral infarctions 11 months after COVID-19 Thrombosis Journal COVID-19 Pulmonary Embolus Stroke Thrombolysis Anticoagulation Coagulopathy |
| title | Multiple simultaneous embolic cerebral infarctions 11 months after COVID-19 |
| title_full | Multiple simultaneous embolic cerebral infarctions 11 months after COVID-19 |
| title_fullStr | Multiple simultaneous embolic cerebral infarctions 11 months after COVID-19 |
| title_full_unstemmed | Multiple simultaneous embolic cerebral infarctions 11 months after COVID-19 |
| title_short | Multiple simultaneous embolic cerebral infarctions 11 months after COVID-19 |
| title_sort | multiple simultaneous embolic cerebral infarctions 11 months after covid 19 |
| topic | COVID-19 Pulmonary Embolus Stroke Thrombolysis Anticoagulation Coagulopathy |
| url | https://doi.org/10.1186/s12959-021-00304-8 |
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