Giant intracardiac thrombosis in an infant with leukaemia and prolonged COVID-19 viral RNA shedding: a case report

Thrombosis Journal

Mojtaba Gorji¹  Amene Navaeian²  Alieh Safari Sharari²  Mehrnoush Afsharipour²  Azin Ghamari³  Ehsan Aghaei Moghadam⁴  Setareh Mamishi⁵  Shima Mahmoudi⁶ 

[1] Department of Pediatric Cardiology, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran;Department of Pediatrics, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran;Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran;Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran;Department of Pediatric Cardiology, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran;Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Children’s Medical Center Hospital, Dr. Gharib Street, Keshavarz Boulevard, Tehran, Iran;Department of Infectious Diseases, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran;Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Children’s Medical Center Hospital, Dr. Gharib Street, Keshavarz Boulevard, Tehran, Iran;Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran;

关键词: SARS-CoV‐2;    Children;    Thrombosis;    Acute lymphoblastic leukemia;    Prolonged viral shedding;   

DOI  :  10.1186/s12959-021-00285-8

来源: Springer

【 摘 要 】

BackgroundCOVID-19 can induce thrombotic disease both in the venous and arterial circulations, as a result of inflammation, platelet activation, endothelial dysfunction, and stasis. Although several studies have described the coagulation abnormalities and thrombosis in adult patients with COVID-19, there is limited data in children. Here, we present an 18-month-old boy with a prolonged SARS-CoV‐2 RNA shedding and chronic right atrial and superior vena cava (SVC) thrombosis.Case presentationAn 18-month-old boy with acute lymphoblastic leukemia (ALL) (pre-B cell ALL) and a history of chemotherapy was referred to our center due to intermittent fever with unknown origin. a positive nasopharyngeal PCR for COVID-19 was reported and stayed positive for eight consecutive weeks The high-resolution computed tomography (HRCT) showed no sign of pulmonary embolism. Initial echocardiography indicated a semilunar thrombotic mass extending from right SVC into the right atrium without coronary or myocardial involvement. Enoxaparin was administered with continuous monitoring of the level of anti-Xa activity. The serial echocardiographic studies found a slow but continuous reduction in the mass size.ConclusionsOur case shows that, as already described in adult patients, clinically relevant thrombosis can complicate the course of pediatric patients as well. In view of the specific and milder manifestations of COVID-19 in children, these complications may pose considerable diagnostic and therapeutic challenges.

【 授权许可】

CC BY