Discussion
Since September 2019 during covid 19 pandemic , many cases of
thromboembolic events have been reported1,
2.The Prevalence of thrombosis among
patients with covid 19 is not fully established , but studies showed
that most of them are venous thromboembolism3. Klok et al., study
revealed that the cumulative incidence of a composite outcome of
vascular events (acute pulmonary embolism, deep-vein thrombosis,
ischemic stroke, myocardial infarction, systemic arterial embolism) was
31%, the incidence of venous thromboembolisms was 27%, and the
incidence of arterial events was 3.7%, among patients in the ICU5.
In this study we report an ICU admitted covid 19 patient with iliac and
infrainguinal arterial thrombosis. Assessment about vasculitis,
antiphospholipid antibody syndrome, systemic lupus erythematosus and
another common causes of arterial thrombosis were unremarkable. There
are several mechanisms which can explain the correlation of covid 19
disease and thromboembolic events. In severe cases of covid 19,
cytokines storm and infection of endothelial cells through
angiotensin-converting enzyme 2 protein cause endothelial damage ,
coagulopathy and complement-induced thrombosis , microangiopathy and
thromboembolic events6-8. So probably covid
19 can be considered the probable cause of thromboembolism in our
patient through these mechanisms.
His study reported a covid 19 patient who developed arterial lower
extremity thrombosis leading to acute ischemia and limb amputation. Our
case and several reports of thromboembolic events among hospitalized
patients of covid19 reveal that health care providers should be aware of
life-threatening thromboembolic events associated with covid 19 so that
prompt and appropriate intervention can be undertaken.