Femoral arterial thrombosis in a young adult following non-severe COVID-19

Veyre, Florian; Poulain-Veyre, Corinne; Esparcieux, Aurélie; Monsarrat, Nicolas; Aouifi, Abdellah; Lapeze, Joel; Chatelard, Philippe

INTRODUCTION: Few cases of arterial thromboembolisms have been reported after 2019 coronavirus disease (COVID-19), in case of severe infection or elderly patients. We report a case of femoral arterial thrombosis in a young patient following non-severe infection. CASE DESCRIPTION: A common femoral artery thrombosis extended in the first third of superficial and profunda femoral arteries associated with tibial posterior and popliteal arteries thrombosis were diagnosed in a 24 year-old man complaining of right lower limb pain for one month. The evolution was good after anticoagulation and antiaggregant treatments and thrombectomy. Etiologic assessment was negative except non-severe COVID-19. DISCUSSION: 2019 coronavirus accesses host cells via angiotensin-converting enzyme 2 protein, abundant in the lung, also expressed by endothelial cells and COVID-19 is associated with important inflammatory syndrome and coagulopathy, leading to vascular lesions. Thrombosis prevalence is not fully established, seems to be higher in case of major inflammation and in intensive care unit (ICU). Arterial thromboembolisms are described in many vascular territories, each time in elderly patients or severe infection. We described a femoral arterial thrombosis in a young patient with negative etiological assessment except non-severe COVID-19. Treatment consists in anticoagulation and antiaggregant drugs and thrombectomy. Preventing venous thromboembolism treatment is recommended in case of severe infection or in ICU but there is no clear recommendation for arterial thromboembolism prevention. This case should lead us to be very careful to arterial event risk even if the infection is non-severe and the patient young.