Pulmonary Arterial Thrombosis in COVID-19 With Fatal Outcome: Results From a Prospective, Single-Center, Clinicopathologic Case Series

Study notes COVID-19 mainly involves lungs, causing diffuse alveolar damage and acute respiratory insufficiency. Autopsy findings (n=10) found death may be caused by thrombosis observed in segmental and subsegmental pulmonary arterial vessels despite prophylactic anticoagulation

SPS commentary:

According to an editorial, autopsy studies have highlighted the importance of thromboembolic events in COVID-19. They refer to study by Wichmann et al who found the high incidence of pulmonary embolism with or without deep venous thrombosis, as well as presence of recent thrombi in prostatic venous plexus, in patients with no history of VTE, suggesting de novo coagulopathy in these patients with COVID-19. In contrast, the current study highlight changes consistent with thrombosis occurring within the pulmonary arterial circulation, in the absence of apparent embolism.

Annals of Internal Medicine