Arterial thrombosis and unusual patterns of thrombotic events in young adults patients with COVID-19 are yet rarely described in this setting and could be underestimated. There is a real need for studies to describe the frequency of unusual thrombotic complications.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first identified in Wuhan,
China in December of 2019, has become a worldwide pandemic with widespread illness and
mortality. Clinical manifestations of Coronavirus disease 2019 (COVID-19) are absent or mild
in a substantial proportion of patients who test positive for COVID-19. Although respiratory
compromise is the cardinal feature of the disease, early studies have suggested that elevated
circulating D-dimer levels are associated with mortality suggesting a distinct coagulation
disorder associated with COVID-19. COVID-19 infection is commonly complicated with
pro-thrombotic state and endothelial dysfunction.
Recent autopsy studies of COVID-19 patients supported this hypothesis by demonstrating the
extensive extracellular fibrin deposition and presence of fibrin thrombi within distended
capillaries and small vessels. Observational studies reported an excess of venous
thromboembolic events (deep vein thrombosis (DVT), pulmonary embolism (PE)) among patients
suffering from Covid-19. Retrospective studies have reported thrombotic rates in excess of
20% to 30%, but the use of prophylactic anticoagulation and duration of treatment were not
consistent between studies. Unrecognized PE and pulmonary in situ thrombosis were reported as
causes of the high mortality observed among COVID-19 patients. There is currently no clear
estimation of the risk of arterial and, in particular, venous thromboembolic complications
which depend on local diagnostic and pharmacological preventive strategies. In addition to
D-dimer, a prolonged prothrombin time (PT) has been associated with decreased survival and
increased need for critical care.
However, arterial thrombosis and unusual patterns of thrombotic events in young adults
patients with COVID-19 are yet rarely described in this setting and could be underestimated
(9). Thus, there is a real need for studies to describe the frequency of unusual thrombotic
complications. Therefore, the purpose of this study will be to explore thromboembolic risk
and associated predicting factors in the young adults' cohort of noncritically ill COVID-19
patients which will help to optimize diagnostic, therapeutic, and preventive strategies of
COVID-19 related thrombosis.
Diagnostic Test: Thrombophilia screening
Genetic thrombophilia and acquired thrombophilia screening
Inclusion Criteria:
- non-critically ill young adults' patients with COVID-19 admitted to our hospital will
have confirmed unusual thrombotic events and accept recruitment to this study.
After that, we will focus only on previously healthy patients without pre-existing
prothrombotic factors and presented with COVID-19 related unusual thrombotic events
Exclusion Criteria:
- COVID-19 patients below 18 years and above 40 years
- COVID-19 patients diagnosed as critically ill COVID-19
- COVID-19 patients with pre-existing diabetes mellitus (DM), hypertension, ischemic
heart disease (IHD), valvular heart disease, cardiomyopathy and chronic arrhythmia,
dyslipidemia, metabolic syndrome, chronic kidney disease, liver disease, nephrotic
syndrome, previous autoimmune disease, and malignancy
- COVID-19 patients with chronic lung disease or immune compromise
- COVID-19 pregnant women
- COVID-19 patient with history of thrombosis/ psychiatric disorders/ drug abuse
- COVID-19 patient previously diagnosis with congenital thrombophilia
- COVID-19 patient with drug history could induce thrombosis.
- COVID-19 patient unwilling to be followed up.
- Patients are previously diagnosed with one or more risk factors of thrombosis
, Faculty of Medicine, Sohag University
Sohag, Egypt
Investigator: Mahmoud I. Elbadry, MD, PhD
Contact: +01065964083
mahmoudibrahim@med.sohag.edu.eg
Not Provided