CC BY-NC-ND 4.0 · Indian J Cardiovasc Dis Women WINCARS 2021; 06(04): 252-255
DOI: 10.1055/s-0041-1739129
Case Report

High Risk of Venous Thrombosis Recurrence in Fully Anticoagulated Patient with Antithrombin Deficiency during COVID-19: A Case Report

Mirjana Kovac
1   Faculty of Medicine, University of Belgrade, Belgrade, Serbia
2   Department of Hemostasis, Blood Transfusion Institute of Serbia, Belgrade, Serbia
Olivera Markovic
3   Department of Hematology, University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia
Sanja Lalic-Cosic
4   Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
Gorana Mitic
5   Center of Laboratory Medicine, Clinical Center of Vojvodina, Faculty of Medicine Novi Sad, University of Novi Sad, Novi Sad, Serbia
› Author Affiliations


Coagulation dysfunction is a serious issue in patients with Coronavirus disease-19 (COVID-19). With regard to recently published studies, a high number of patients with acute respiratory distress syndrome (ARDS) secondary to COVID-19 developed life-threatening thrombotic complications despite anticoagulation. We report a case of young woman with the type-II heparin-binding site (HBS) antithrombin (AT) deficiency (Budapest 3-homozygous), who developed acute deep vein thrombosis on two occasions due to COVID-19 infection in the course of stable anticoagulation with vitamin K antagonist. The first thrombotic event was observed during mild COVID-19 infection, while the second thrombotic event she developed 2 months after she was negative for severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2). Our case highlights the complexity of the treatment in this particular type of thrombophilia and the need for precaution even in mild forms of viral infection. In the treatment of acute thrombosis, AT-deficient patients may benefit from the use of AT concentrate along with low-molecular weight heparin (LMWH), while in cases of type II-HBS, AT supplementation is mandatory.

Publication History

Article published online:
14 December 2021

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