Abstract
The coronavirus disease (COVID-19) pandemic has rapidly spread across the globe since its first detection in March 2020. Its widespread manifestations and vascular complications are increasingly being reported even in young and middle-aged patients. Hyperinflammation is a continuum of host's exaggerated inflammatory response representing cytokine dysregulation/storm which produces coagulopathy and vascular endothelial dysfunction, apart from a prothrombotic state. Cytokine storm or direct viral invasion of the vascular endothelial cells through surface angiotensin-converting enzyme 2 receptors may result in endothelial dysfunction which can potentially result in dissection. Only a few case reports have been published in the literature describing vascular dissection without any inciting factors in COVID-19 patients. Herein, we present the first case report of bilateral renal artery dissection in a 41-year-old male patient who recently recovered from COVID-19 and was managed successfully in stages after many medical hurdles.
Highlights
Coronavirus disease (COVID-19) was declared as a pandemic in March 2020; since it has rapidly spread across the globe and infected well over 54 million people worldwide [1]
Cytokine storm or direct viral invasion of the vascular endothelial cells through surface angiotensin-converting enzyme 2 (ACE2) receptors may result in endothelial dysfunction which can potentially result in dissection [10, 11]
Published literature and reports have postulated that it causes severe hypercoagulable stage and cytokine storm that may lead to thromboembolic events and vascular endothelial injury that may affect the vessel wall which rarely can lead to dissection [12,13,14,15]
Summary
Coronavirus disease (COVID-19) was declared as a pandemic in March 2020; since it has rapidly spread across the globe and infected well over 54 million people worldwide [1]. The clinical manifestations are primarily classified into three stages: stage I of early infection, stage II of pulmonary involvement, and stage III of hyperinflammation [3]. COVID-19 produces a severe hypercoagulable state which may lead to both venous and arterial thromboembolic events such as stroke, pulmonary embolism, renal infarcts, and limb ischemia [7,8,9]. A few case reports have been published in the literature describing vascular dissection without any inciting factors in COVID-19 patients [12,13,14,15]. We present the first case report of renal artery dissection in 41-year-old male patient who recently recovered from COVID-19
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