Background: It is known that patients with COVID-19 are at increased risk of thrombosis. Although
COVID-19 infection primarily affects the lower respiratory tract system, emerging reports suggest direct
and indirect cardiovascular complications. However, the key mechanisms under thrombosis development at
great arterial vessels are still unclear.
Case presentation: We report the cases of 4 patients who were admitted to our hospital and suffered from
arterial thrombotic complications. All of them were older than 60 years and only 1 did not have cardiovascular
risk factors. It should be noted that days prior to the diagnosis of arterial thrombosis, 3 of the 4 patients were
under anticoagulant treatment. It is also interesting that in contrast to already known typical microvascular
locations, our patients suffered from large arterial vessels thrombosis. Furthermore, none of them would
present with severe respiratory symptoms.
Conclusion: The underlying mechanism of COVID-19-associated arterial thrombosis remains unclear
and might be independent of the cytokine storm that occurs in patients with COVID-19-associated venous
thrombosis. Also, the role of anti-platelets agents as prophylactic treatment in high-risk patients remains
unclear. Multicenter clinical trials are necessary to clarify these issues.
Author(s): Sergio Ramos Cill?n, Laura Sol?n Blanco , Marta Tom?s Mallebrera, Ana B. Arribas D?az, Javier Cornago Navascu?s, Alberto L?pez Garc?a, Carola D?az Aizp?n, Jos? Luis L?pez Lorenzo, Mar?a Pilar Llamas Sillero
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