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Published in

Oxford University Press, Oxford Medical Case Reports, 11(2020), 2020

DOI: 10.1093/omcr/omaa096

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Large-vessel thrombotic stroke despite concurrent therapeutic anticoagulation in COVID-19-positive patient

Journal article published in 2020 by Andrew Shoukry ORCID, Thomas A. Kite ORCID
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

ABSTRACT The current COVID-19 pandemic caused by the novel SARS-CoV-2 virus is now recognized to be associated with a coagulopathy that can result in arterial and venous thromboses. In this report, we describe a case of large-vessel cerebrovascular thrombus in a therapeutically anticoagulated 89-year-old male admitted with COVID-19 infection. Despite clinical improvement following COVID-19 pneumonitis, symptoms of an acute left-sided total anterior circulation stroke rapidly developed 10 days after initial COVID-19 symptom onset. Computed tomography angiography imaging confirmed acute large-vessel thrombus in the terminal segment of the internal carotid artery resulting in acute right middle cerebral artery territory infarction. Thromboembolic events in the context of COVID-19 infection have recently been described in critically unwell patients. However, to the best of our knowledge, this is one of the first cases of large-vessel thrombus in a patient with COVID-19 infection receiving concurrent therapeutic anticoagulation.