A 60-year-old woman with Hepatitis C infection, cirrhosis, recurrent hepatic hydrothorax, and hepatocellular carcinoma was hospitalized with Coronavirus disease-2019 (COVID-19). After her initial discharge, she was re-admitted three weeks later with decompensated liver disease. Imaging revealed extensive thrombosis in the portal vein, superior mesenteric vein, splenic vein and bilateral brachial veins. Given the acute onset and extent of the thrombosis, the patient received therapeutic anticoagulation despite elevated prothrombin time/ international normalized ratio, thrombocytopenia and low fibrinogen. Cirrhotic patients with COVID-19 maybe at high risk of thrombosis, which can present with significant hepatic decompensation.
Keywords: COVID-19; COVID-19, Coronavirus disease-2019; Coagulopathy; DIC, disseminated intravascular coagulation; HCC, hepatocellular carcinoma; HCV, Hepatitis C virus; Liver cirrhosis; MRI, magnetic resonance imaging; PVT, Portal vein thrombosis; SMV, superior mesenteric vein; Thrombosis.
© 2022 The Author(s).