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CC BY 4.0 · Aorta (Stamford) 2022; 10(03): 104-113
DOI: 10.1055/s-0042-1748960
Original Research Article

COVID-19-Associated Large- and Medium-Sized-Vessel Pathology: A Case Series

Stacey Chen 
1   Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York
,
Jad Malas 
1   Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York
,
Larry A. Latson Jr
2   Department of Radiology, New York University Langone Health, New York, New York
,
Navneet Narula
3   Department of Pathology, New York University Langone Health, New York, New York
,
Amy V. Rapkiewicz
3   Department of Pathology, New York University Langone Health, New York, New York
,
David M. Williams
1   Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York
,
Harvey I. Pass
1   Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York
,
Aubrey C. Galloway 
1   Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York
,
Deane E. Smith
1   Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York
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Funding None.
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Abstract

Background Coronavirus disease-19 (COVID-19) remains a public health crisis. The epidemiology of COVID-19-associated large- and medium-sized-vessel pathology is not well characterized. The aim of this study is to identify patients with possible COVID-19-associated large- and medium-sized-vessel pathology based on computed tomography (CT) imaging to provide insight into this rare, but potentially devastating, cardiovascular manifestation.

Methods This is a single-center retrospective review of patients with CT chest, abdomen, and/or pelvis concerning for large- and medium-vessel pathology and confirmed COVID-19 infection from March 1, 2020 to October 31, 2020.

Results During the study period, 6,553 CT reports were reviewed and pertinent imaging was identified in 139 patients. Of these, 8 patients (median age: 59 years, range 51–82) were COVID-19 positive. All patients had preexisting cardiovascular risk factors and three (37.5%) had an autoimmune disease. Four patients were never hospitalized for COVID-19. Among these, two presented to the hospital at a median of 39 days (range: 27–50) after their initial COVID-19 test with chest and back pain where imaging revealed extensive aortic pathology. One patient required surgical management for aortic pathology. All other patients were treated with expectant management and outpatient follow-up.

Conclusion The clinical and radiological presentations of COVID-19-associated large- and medium-vessel pathology are heterogeneous and can be a late finding after COVID-19 recovery. Close clinical follow-up and surveillance imaging for large- and medium-sized-vessel pathology may be warranted in COVID-19 patients.

Keywords

COVID-19 - aortitis - large-vessel vasculitis - medium-vessel vasculitis


Publikationsverlauf

Eingereicht: 25. März 2021

Angenommen: 09. September 2021

Artikel online veröffentlicht:
01. November 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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