Covid-19 has a strong inflammatory effect on vein walls. Together with other risk factors, Covid-19 infection creates a major thrombogenic risk. Using a case description, we shed light on the vascular surgical view of the clinical and therapeutic problems.The risk factors for superficial vein thrombosis (OVT) are close to those for Venous Thromboembolism (VTE). However, the risk of these superficial cutaneous vein thromboses is considerably higher if there are already varicose veins (defective venous valves with a subsequent standing blood column and pathological backflow into the lower leg veins!). This reflux increases the pressure in the deep veins to over 100 mmHg - and with that alone there is a high risk of thrombosis. Now a virus is added, which obviously accumulates and multiplies in all inner walls of the vessels. This also applies to the vascular wall of varicose veins [1-5]. CASE STUDY Pathophysiological considerations: COVID-19 and varicose veins: common cause of deep vein thrombosis and embolism As can already been read in some publications, COVID-19 causes inflammation of the vascular wall of the deep leg veins - this alone has a thrombotic effect. In this case, however, the question must be asked whether the vein wall inflammation of the varicose vein does not exist first and whether the superficial thrombosis, which therefore develops very quickly, migrates into the deep veins of the leg, which have already been damaged by the virus. This then leads to the, often fatal pulmonary embolism, currently with Covid-19. However, this pathological process was discussed 50 years ago and can be found in our literature research in many older scientific articles.Varicose veins are the main cause of OVT of the lower extremities, but underlying diseases (e.g. autoimmune diseases, infections, malignancy or thrombophilia) that already exist in parallel must also be looked for in superficial cutaneous vein thrombosis [6-8]. A simultaneous deep vein thrombosis after cutaneous vein thrombosis of varicose veins occurs in 15% of all affected. The severe complication pulmonary embolism can be seen in around 5% of those affected. However, these numbers do not yet take into account the pathological influence of various viruses - such as Covid-19.

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