A Peculiar Case of Priapism: The Hypercoagulable State in Patients with Severe COVID-19 Infection

Germain Lam; Rowan McCarthy; Rana Haider

doi:10.12890/2020_001779

A Peculiar Case of Priapism: The Hypercoagulable State in Patients with Severe COVID-19 Infection

Eur J Case Rep Intern Med. 2020 Jul 14;7(8):001779. doi: 10.12890/2020_001779. eCollection 2020.

Authors

Germain Lam¹, Rowan McCarthy¹, Rana Haider¹

Affiliation

¹ General Internal Medicine, Withybush General Hospital, Haverfordwest, Pembrokeshire, United Kingdom.

Abstract

It is increasingly recognised that patients with severe COVID-19 infection have a significant risk of thromboembolic events. We describe a patient who rapidly deteriorated due to severe infection with COVID-19, and developed priapism in the last days of his life. We believe development of priapism may be associated with a prothrombotic state secondary to COVID-19 infection. This case report supports the widely reported increased incidence of thrombosis in patients with severe COVID-19 infection.

Learning points: Prophylactic doses of anticoagulation may not be sufficient in patients with severe COVID-19 infection, but clinical trials of therapeutic dose anticoagulation are underway.Physicians should be vigilant and have a high suspicion for thrombosis in all patients with COVID-19 infection, even those who are anticoagulated.Presentations of thromboembolism and microemboli may be atypical.

Keywords: COVID-19 infection; Priapism; anticoagulation; coagulopathy; thromboembolism.