Trending Clinical Topic: Thrombotic Storm

Ryan Syrek

Disclosures

June 19, 2020

Each week, we identify one top search term, speculate about what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what's trending and why, share them with us on Twitter or Facebook. Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

A focus on the relationship between heart conditions and COVID-19 resulted in this week's top trending clinical topic. Details from a study published by a group of interventional cardiologists from Spain suggest a concern about stent thrombosis in patients with coronavirus infection. The findings detail four cases of what has been called a "thrombotic storm." The authors suggest that these cases are associated with coronavirus-related hypercoagulability that triggered thrombotic complications. This has prompted doctors to be more vigilant with thromboprophylaxis and check for clotting risk in patients with COVID-19.

The cardiac concerns associated with COVID-19 are numerous, even for those without coronavirus infection. Individuals who are having heart attacks, strokes, or other heart conditions are avoiding hospitals during the pandemic out of fear of contracting the infection. Cardiologists have noted that COVID-19 not only worsens existing cardiovascular disease but can also cause new heart issues. The potential of SARS-CoV-2 to promote inflammation and result in thrombosis is responsible for many complications associated with COVID-19.

Patients with heart transplants are at especially increased risk. A new study found that COVID-19 infection is associated with an increased mortality risk in this patient population. Data on 28 patients with confirmed infection who received a heart transplant between March 1 and April 24, 2020, revealed a case-fatality rate of 25%. In terms of prevention, although the research did not find a protective effect from immunosuppression against COVID-19, further studies are needed.

Even healthy individuals who have not undergone a major heart procedure should be wary of potential cardiac concerns associated with coronavirus infection. Sports cardiologists have suggested that athletes should rest for at least 2 weeks after COVID-19 symptoms resolve before resuming high-level competitive sports and other intense activities.  A recently published clinical algorithm sorts athletes on the basis of coronavirus test status and symptom severity, and provides a clear timeline for safer resumption of activity along with management recommendations.

Although SARS-CoV-2 has been identified as causing significant complications across a host of different systems, cardiac concerns are among the most closely watched. This explains why findings related to stent thrombosis resulted in this week's top trending clinical topic.

Read more clinical information about COVID-19.

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