Multisystemic Infarctions in COVID-19: Focus on the Spleen
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The literature suggests that COVID-19 provokes arterial and venous thrombotic events, although the mechanism is still unknown. This study describes patients with confirmed coronavirus infection associated with multisystemic infarction, focusing on splenic infarction.

Case 1: A 67-year-old, previously hypertensive, male patient was admitted with a 1-day history of weakness in the left upper limb and drooping of the mouth. The patient reported having cough, headache and mild dyspnoea for about 10 days. Naso- and oropharyngeal swabs using the RT-PCR method and rapid test were both positive for SARS-CoV-2 coronavirus infection. CT images showed an area of acute ischemic stroke in the brain; ground-glass opacities, pulmonary consolidations and findings suggestive of pulmonary thromboembolism; as well as areas suggestive of splenic infarction.

Case 2: A 53-year-old female patient with rheumatoid arthritis reported dry cough, fever and anosmia, together with dyspnoea. A naso/oropharyngeal swab using the RT-PCR method was positive for SARS-CoV2 coronavirus. The CT images showed areas suggestive of splenic infarction, which was also seen on ultrasound; CTA confirmed filling failures in the subsegmental branches of the splenic artery. Chest CT scan showed ground-glass opacities and mosaic paving, suggestive of viral infection.

Conclusively, In the current pandemic, clinicians should be aware of thrombotic disease as a complication of COVID-19 and radiologists should monitor patients for thrombosis to facilitate early diagnosis. Further studies should be carried out to elucidate the pathophysiological mechanisms of COVID-19-related coagulopathy, and so that early preventive and therapeutic strategies can be developed to reduce morbidity and mortality.