The novel coronavirus disease (COVID-19) is not only a respiratory illness but also predisposes to cardiovascular diseases such as thromboses, strokes, myocardial infarctions, and arrhythmias due to infection of vascular endothelial cells and cytokine storm in the whole body. Cardiovascular disease, as an underlying condition, worsens the prognosis of COVID-19 and has a significant impact on the system of care. In addition, the increased risk of developing cardiovascular disease after sequelae and infection, referred to as Long COVID, is problematic.

Vasa vasorum forms a network of capillaries and veins on the outer surface of the aortic tunica media and adventitia, which plays an important role in the structure and function of the aortic wall, but it has long been argued that its dysfunction may contribute to tissue hypoxia and hypotrophy, leading to degeneration and weakening of the aortic tunica media and eventually aortic dissection. In this review, we would like to discuss the role of vasa vasorum in the pathogenesis of aortic dissection based on previous literature.

A 55-year-old man with von Recklinghausen disease complained about fever and coughing. We diagnosed him as COVID-19. He admitted our hospital to take injection of antiviral agent. Day 5 of hospitalization, he had a backache and respiratory failure. We investigated him and diagnosed vascular rupture of branch of right subclavian artery. We performed transcatheter arterial embolization to arrest hemorrhage. However, he died of multiple organ failure. We report a case of vascular rupture of right subclavian artery with von Recklinghausen disease after infected COVID-19.