Successful treatment of ascending aortic thrombosis associated with coronavirus disease 2019: Case report.

UNLABELLED

Coronavirus disease 2019 (COVID-19) has been associated with arterial thrombosis, including aortic thrombus with embolism as well as venous thrombosis. We report a case of a 59-year-old man with COVID-19 showing thrombus in the ascending aorta and occlusion of the lower limb artery on computed tomography. Anticoagulant therapy via continuous intravenous infusion of heparin was started with a therapeutic target range (activated partial thromboplastin time 42-70 s, 1.5-2.5 × patient baseline). The patient was then transferred to warfarin medication and prothrombin time-international normalized ratio was managed at 1.5-2.5. The disappearance of the thrombus was confirmed on the 20th day after starting anticoagulant therapy. Anticoagulant therapy was then discontinued, and computed tomography angiography (CTA) 3 months later showed no recurrence of aortic thrombi or embolism. Anticoagulant therapy alone may be considered for arterial thrombosis in COVID-19 and follow-up CT may allow for early discontinuation of anticoagulant therapy to confirm disappearance of thrombus.

LEARNING OBJECTIVE

Coronavirus disease 2019 (COVID-19) is recognized to cause arterial thrombosis as well as venous thrombosis. However, treatment of aortic thrombosis in patients with COVID-19 has not yet been established. Anticoagulants alone may be effective against aortic thrombi in patients with COVID-19 and follow-up computed tomography may allow for early discontinuation of anticoagulant therapy to confirm disappearance of thrombus.