Abstract
Coronavirus 2019 disease (COVID-19) is a viral illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It emerged in Wuhan, China, in December 2019 and has caused a widespread global pandemic. The symptoms of COVID-19 can vary from mild upper respiratory symptoms to severe pneumonia with hypoxemic respiratory failure. Multiple studies and reports have reported a hypercoagulable state associated with this disease, and various recommendations have emerged to guide the use of anticoagulants for prophylaxis. We are reporting a case of symptomatic acute splenic thrombosis causing splenic infarction in a patient suffering from a severe case of COVID-19 and despite the use of an intermediate dose of low-molecular-weight heparin (LMWH). The patient was treated with full-dose anticoagulation and was eventually discharged home on a direct oral anticoagulant.
Highlights
21 million individuals have been diagnosed with COVID-19 worldwide, and approximately 761 thousand fatalities have been reported as of August 21, 2020 [1]
Hypercoagulability leading to venous thromboembolism (VTE) and arterial thrombosis has been reported in multiple studies, and various recommendations to prevent these events have emerged
A male patient in his 60s presented to the emergency department with worsening dyspnea for two weeks. It was associated with fevers, cough, and diarrhea. He tested positive for COVID-19 one week prior to presentation, and he was started on hydroxychloroquine 400 mg daily by his primary care physician, but his symptoms continued to progress
Summary
21 million individuals have been diagnosed with COVID-19 worldwide, and approximately 761 thousand fatalities have been reported as of August 21, 2020 [1]. Hypercoagulability leading to venous thromboembolism (VTE) and arterial thrombosis has been reported in multiple studies, and various recommendations to prevent these events have emerged. Multiple ongoing studies are still evaluating the most appropriate dosing to prevent VTE
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