Background and Aims: The Nutrition Risk in Critically ill (NUTRIC) score is an appropriate nutritional assessment tool in mechanically ventilated patients. We retrospectively observed the applicability of the NUTRIC score for predicting outcomes in coronavirus disease (COVID)-19 acute respiratory distress syndrome (ARDS) patients. Methods: All adult COVID-19 ARDS patients admitted to the intensive care unit and requiring various forms of oxygen therapy were included in the study. The demographic characteristics and clinical information about the patients were obtained from the hospital's medical records department. The nutritional risk for each patient was assessed using the NUTRIC score at 72 hours of ICU admission. The discriminating power and ability of NUTRIC score, Sequential Organ Failure Assessment (SOFA) score, age and Acute Physiology and Chronic Health Evaluation (APACHE) II to predict the 28-day mortality and need for mechanical ventilation (MV) was calculated using receiver operating characteristic curves and area under this curve. Results: A total of 80 COVID-19 ARDS patients fitted into the inclusion criteria. Among non-survivors, the median Glasgow Coma Score, APACHE II score, NUTRIC score and SOFA score were 10, 16, 6 and 4, respectively. The cut-off values for NUTRIC score, SOFA, and APACHE II to predict 28-day mortality and need for MV was obtained as 3.5, 3.5 and 11.5, respectively. These cut-off values of NUTRIC score, SOFA score, and APACHE II have a sensitivity of 62%, 72.5% and 75.5%, respectively, and specificity of 95%, 72% and 83% for predicting mortality. Conclusions: Most COVID-19 ARDS patients requiring MV in the ICU are at nutritional risk, and a high NUTRIC score is associated with higher mortality.

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A bstract Coronavirus disease-2019 (COVID-19) disease is often complicated by venous thrombosis and embolism. However, arterial thrombosis in a patient already on therapeutic anticoagulation is a rare occurrence. In one patient, we found thrombosis of the radial artery leading to ischemia of the fingers and lateral part of the palm. In another patient, thrombosis was found in the anterior tibial artery, resulting in ischemia of the limb and amputation. Both these patients were on a therapeutic dose of low-molecular-weight heparin. In both cases, heparin infusion was started but with little benefit. It is suggested that intensified anticoagulation should be done in patients at high-risk venous thrombosis, and prompt interventional thrombectomy should be done in cases of failure of pharmacological anticoagulation. How to cite this article Kumar A, Kumar N, Arun SK, Ghosh S, Pattanayak A. Acute Peripheral Arterial Thrombosis in COVID-19 Patients on Therapeutic Anticoagulation. Indian J Crit Care Med 2021;25(4):461–462.