Thrombotic Complications in SARS CoV-2 IgG Positive Patients with Asymptomatic COVID-19 Infection

Background: Covid-19 disease has potential to result in a wide range of manifestations. Several studies have reported thromboembolic complications of Coronavirus Disease of 2019 (COVID-19). Therefore, we aim to discuss and analyze reported four cases of asymptomatic, positive SARS CoV–2 IgG antibodies Covid-19 infection with various thrombotic complications in the Dr. Hedgewar Hospital.

Methods: We reported and analyzed the clinical, radiographic, and laboratory manifestations, co-morbidity, pathophysiological mechanisms associated with thrombotic complications. Published literatures related to thrombotic complications were also searched in pubmed and embase and reviewed with the case study results.

Case discussion: First case of left sided hemiplegia was diagnosed with right-sided Middle Cerebral Artery (MCA) territory infarct. Second case presented with pulmonary thromboembolism, third case had peripheral vascular disease, and the fourth case had thrombosis involving abdominal aorta and bilateral renal arteries. In all these cases, no significant risk factors were found except rise in inflammatory markers (D-dimer and C reactive protein (CRP)). The results correlate with findings by various studies. Based on evidences, exaggerated state of hyper coagulation was attributed to COVID-19 disease pathogenesis.

Conclusion: The evidence from these cases implies that SARS CoV-2 infection can lead to vascular thrombosis in symptomatic as well as asymptomatic patients.