The University of Toledo Translation Journal of Medical Sciences 
Hospital Medicine Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

A patient with Factor V Leiden mutation 
who developed a Pulmonary Embolism and 
Deep Vein Thrombosis post Covid 
N. Rehman, M41*, L. Brant, M41, A. Mahmood, MD1 

1Division of Hospital Medicine, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 

*Corresponding author: naveeen.rehman@rockets.utoledo.edu

Published: 05 May 2023 

Introduction: A well-known sequelae of infection with Covid-19 is coagulopathy, which presents as a 
prothrombotic state in the acute and chronic phases of infection. Current literature outlines the incidence 
of Covid coagulopathy in patients without a previous history of hypercoagulability, however few sources 
have examined the consequences of Covid coagulopathy in patients with existing prothrombotic states. 
We present a case of a patient with a known hypercoagulable condition presenting with covid 
coagulopathy.    

Case Presentation: A 53-year-old male with a past medical history of Factor V Leiden mutation on 
warfarin, atrial fibrillation, and Covid pneumonia complicated by hypoxic respiratory failure 6 weeks 
ago presented to the emergency department at the University of Toledo with a chief complaint of 
bilateral arm pain of 2 days duration, along with redness and swelling of his arms. Patient reportedly had 
a supratherapeutic INR of 8.8 two days prior to presentation, and became subtherapeutic after vitamin K 
administration, with an INR of 1.64 one day prior to presentation. In the ED, physical exam was notable 
for diminished pulses in the upper extremities. CT of the upper extremities was negative for arterial 
occlusion, but CTA chest did reveal a pulmonary embolism. Patient had recurrent pain in the arms, and 
on day 3 of admission, ultrasound of the upper extremities revealed bilateral deep venous thromboses.   

Conclusion: Patients with known thrombophilic disorders are at risk for covid coagulopathy. Closer 
monitoring of anticoagulation therapies is warranted for these patients who contract Covid-19 to 
minimize the risk of thromboembolic events. 

https://dx.doi.org/10.46570/utjms.vol11-2023-742 

https://dx.doi.org/10.46570/utjms.vol11-2023-742
mailto:naveeen.rehman@rockets.utoledo.edu