Peripheral Vascular Complications in COVID-19: Bilateral and Multiple Extensive Thrombophlebitis of the Lower Limbs

Abstract

Background: COVID-19 infection is now a serious global pandemic (declared by WHO on 11 March 2020), inflicting significant morbidity and mortality, and the rapidly increasing numbers of the infected cases constitutes a burden on the health care system and the economy even in the developed countries. The objective of this case study is to highlight the peripheral vas-cular complications of COVID-19 as the published articles regarding this subject are scarce.
Methods: It is a case report of a 41 year female patient that developed laboratory confirmed (RT-PCR) COVID-19 infection of moderate severity that needed hospitalization for 3 weeks with no need to ICU, and the patient was discharged after improvement. One month later she had peripheral vascular complications in the form of bilateral and multiple extensive thrombophlebitis of her lower limbs. Unfortunately, there was one more month lag before reaching to proper diagnosis and management and the patient was not anticoagulated during all this period since the onset of her COVID-19 infection. She was properly managed on an outpatient basis by LMWH then one of the DOACs together with Aspirin and the patient is being followed for 3 months up till now with excellent results.
Conclusion: COVID-19 can cause hypercoagulability state, resulting in venous thromboembolism and pulmonary embolism with fatal outcome so that all patients with severe COVID-19 infection should be routinely anticoagulated. We should also be aware of the peripheral vascular complications of COVID-19 either venous or arterial not to be missed in diagnosis and should be properly managed.