Novel coronavirus disease 2019 (COVID-19) is known to lead not only to severe acute respiratory syndrome, but also can result in thromboembolic events in both the venous and the arterial circulation by inducing coagulation disorders. The potential causes of coagulopathy are inflammation, platelet activation, endothelial dysfunction, and stasis. The thrombotic events including pulmonary embolism, deep venous thrombosis as well as intracatheter thrombosis are more likely to develop in patients infected with severe form of SARS-CoV-2 who are admitted to ICU. Furthermore, these events contribute to multi-organ failure. Herein, we report a case of an immunocompromised COVID-19 elderly patient with acute lymphocytic leukemia who developed myocardial infarction with ST elevation in the setting of acute pulmonary thromboembolism in the presence of zero platelet count. Despite successful urgent coronary revascularization and platelet transfusion, the patient eventually died after failed resuscitation efforts. Patients with COVID-19 infection are at a greater risk of developing cardiovascular complications, but their appropriate management can decrease the risk of fatal events. Coronary thrombosis associated with pulmonary thromboembolism in the setting of thrombocytopenia is a rare and a complex to manage condition. Significance of single antiplatelet agent in STEMI with thrombocytopenia merits further studies. According to expert opinions and literature reviews, we must avoid dual antiplatelet therapy in these patients and keep platelet transfusion as a standard therapy to avoid drastic bleeding complications.

中文翻译：

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在SARS-CoV背景下，罕见的老年急性淋巴细胞白血病和血小板计数为零与ST抬高型心肌梗死，肺血栓栓塞相关的老年患者的报道2：病例报告

众所周知，新型冠状病毒病2019（COVID-19）不仅会导致严重的急性呼吸系统综合症，而且还可以通过诱发凝血障碍导致静脉和动脉循环血栓栓塞事件。凝血病的潜在原因是炎症，血小板活化，内皮功能障碍和淤滞。在重症监护病房（SARS-CoV-2）感染重症监护病房的患者中，包括肺栓塞，深静脉血栓形成和导管内血栓形成在内的血栓形成事件更有可能发生。此外，这些事件导致多器官衰竭。在此处，我们报道了一例免疫功能低下的COVID-19老年急性淋巴细胞白血病患者，该患者在血小板计数为零的情况下在急性肺血栓栓塞的情况下发展为ST抬高的心肌梗塞。尽管成功进行了紧急的冠脉血运重建和血小板输注，但该患者最终因复苏努力失败而死亡。COVID-19感染的患者发生心血管并发症的风险更大，但适当的管理可以降低致命事件的风险。在血小板减少的情况下，与肺部血栓栓塞相关的冠状动脉血栓形成是罕见的，而且要处理复杂的疾病。值得进一步研究的是在血小板减少症的STEMI中使用单一抗血小板药的意义。根据专家意见和文献评论，