Researchers from Rutgers University in the United States detail in a study the case of an 85-year-old patient with recurrent blood clots in the left arm after a Covid-19 infection.
- Researchers report the unique case of an 85-year-old man who twice presented blood clots in the arm after being infected with Covid-19. During his second infection, he had no symptoms.
More than a year after the discovery of SARS-CoV-2, researchers are still discovering rare but potentially serious side effects to a Covid-19 infection. In a study published in the journal Viruses, researchers from the Robert Wood Johnson School of Medicine at Rutgers University in New Jersey, describe the case of an 85-year-old man who developed a recurrence of blood clots in his arm. This discovery provides insight into how inflammation caused by Covid-19 can lead to blood clots in the upper extremities and how best to treat them.
A very rare recurring case
The case study is part of a larger study conducted by Rutgers of 1,000 patients hospitalized after a Covid-19 infection between March and May 2020.
Cases of deep vein thrombosis of the lower extremities following Covid-19 infection have already been listed, but this is the first study of recurrence in the left arm of an 85-year-old man who had already diagnosed with upper extremity blood clots.
“The patient presented to his GP complaining of swelling in his left arm and was sent to hospital for further management. He was diagnosed with a blood clot in his upper arm and a asymptomatic infection with Covid-19, says Payal Parikh, assistant professor of medicine at Rutgers Robert Wood Johnson Medical School, who co-led the study. Although his oxygen levels did not decrease, he was hospitalized for management of the upper extremity deep blood clot. Often, blood clots are preceded by chronic inflammatory conditions exacerbated by immobility, and they rarely occur in patients who are otherwise healthy and active to begin with.”
A risk of pulmonary embolism, infarction or stroke
Most cases of deep vein thrombosis occur in the legs. Only about 10% of blood clots occur in the arms, and of those cases, only 9% recur.
“This is concerning because in 30% of these patients the blood clot can travel to the lung and be potentially fatal”, emphasizes Dr. Parikh. The clot can indeed go up to the lungs, block the arteries there and cause a pulmonary embolism. In the heart, it can lead to a heart attack, and in the brain, to a stroke. “Other disabling complications include persistent swelling, pain and arm fatigue.”
These results suggest that clinicians should consider testing for deep vein thrombosis and testing for Covid-19 in patients who complain of unexplained swelling in the upper or lower limbs. People who test positive for Covid should see a doctor if they experience low oxygen levels, shortness of breath and any unexplained swelling.
“If you have been previously diagnosed with deep vein thrombosis or have a chronic condition that predisposes you to blood clots, you are at higher risk of a recurrence of a deep vein thrombus in the setting of infection with Covid-19 and therefore you must be vigilant”concludes Dr. Parikh.
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