How Should Concurrent Arterial and Venous Thrombosis Associated With SARS-CoV-2 Infection Be Managed?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), is associated with a high incidence of thrombotic complications involving both the arterial and the venous systems. However, concurrent arterial and venous thrombosis is extremely rare. Herein, we present the case of a 75-year-old male patient with severe COVID-19 who developed bilateral renal artery thrombosis and pulmonary embolism during the disease course. To our knowledge, this is the first such case described in the literature. LEARNING POINTS: SARS-CoV-2-related coagulopathy is associated with both arterial and venous thrombotic events, which increase morbidity and mortality. Concurrent arterial and venous thrombotic events attributed to SARS-CoV-2 are extremely rare. A high index of clinical suspicion is required, while further research is needed to determine the optimal type, dose and duration of anticoagulation in such cases.