Introduction Multiple studies suggest that SARS-CoV-2 infection is associated with a pro-thrombotic state and thrombotic events have been recorded in several organs and systems. We report a patient with no respiratory symptoms, presented with abdominal pain and an extensive splenic infarction after COVID-19. Case report A 67 year-old man was admitted to the emergency department with a moderate, dull, left-sided abdominal pain. The patient denied respiratory symptoms but referred contact with family members positive for COVID-19. He tested positive for COVID-19 and had increased D-dimer levels. Imaging studies revealed splenic infarcts and ground-glass opacities in bilateral pulmonary bases. He was treated with full-dose anticoagulation and was discharged home on oral Rivaroxaban. Discussion Although rare in the literature, cases of acute abdomen in COVID-19 patients associated with vascular infarctions have increased. Coagulopathy may be present even without clinical respiratory manifestations of the disease. Patients meeting disseminated intravascular coagulation criteria or with markedly elevated D-dimer may benefit from anticoagulant therapy. Conclusion Clinicians should suspect of abdominal visceral infarctions in COVID-19 patients presented with acute abdominal pain, despite the absence of respiratory symptoms.
【저자키워드】 COVID-19, SARS-CoV-2, Disseminated intravascular coagulation, Splenic infarction, 【초록키워드】 anticoagulation, SARS-COV-2 infection, D-dimer, abdominal pain, ground-glass opacity, imaging, Patient, moderate, Contact, COVID-19 patient, Infarction, criteria, respiratory symptoms, anticoagulant therapy, rivaroxaban, Vascular, D-dimer levels, respiratory symptom, positive, Multiple, organ, bases, abdomen, benefit, thrombotic event, discharged home, tested, the disease, elevated, treated, absence, recorded, pro-thrombotic, respiratory manifestation, visceral, 【제목키워드】 Case report, Patient, Infarction, literature review, Splenic,